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Volume 8 Journal of Gastrointestinal & Digestive System Gastro Meet 2018
August 06-07, 2018
August 06-07, 2018 Abu Dhabi, UAE
Gastroenterology and Digestive
Disorders
16th International Conference on
Response to proton pump inhibitor therapy in a racially diverse cohort of pediatric eosinophilic esophagitis
Seema Khan
Children’s National Medical Centre, USA
Background: Eosinophilic Esophagitis (EoE) is a chronic immunologic disorder characterized by esophageal dysfunction and
dense esophageal eosinophilia. The incidence rates are 5.1 and 7 per 100,000 person years in children and adults, respectively.
An initial histologic response to proton pump inhibitor has long been viewed as favoring gastroesophageal reflux disease and
its use is thus proposed in the diagnostic approach. It is evident from recent literature that PPI therapy has an anti-eosinophil
effect, thereby inducing a histologic response independent of GERD status.
Aim: Investigate the response to the initial PPI regimen in children with EoE.
Methods: We performed a retrospective review of data pertaining to children referred to the multidisciplinary EoE clinic at
CNMC. We included children with EoE (peak>15 EOS/HPF at any esophageal level) who underwent a histologic reassessment
after 8 weeks of PPI (1-3 mg/kg/day) at CNMC. Histologic response was defined as 5-15 EOS/HPF and remission as <5 EOS/HPF.
Results: We reviewed data for 71 children with EoE, age 8 mo-17 yr (6 yr ), Caucasian 26 (36.6%) and 43% African Americans
(AA) among non-Caucasians. Only 15 children met inclusion criteria comprising of 73%males, 53% non-Caucasians including
33% AA, age range 1-17 year (7.6 year). Histologic remission with minimal symptomatic improvement occurred in only one
patient. The pre-PPI and post-PPI therapy peak EOS/HPF were 10-100 (52) and 1-100 (54), p=0.74.
Conclusions: We did not observe PPI therapy as sufficient to alter esophageal histologic status favorably in contrast to adults
with EoE. To our knowledge, our Pediatric EoE, is the only uniquely non Caucasian predominant cohort reported to date. The
retrospective nature, variable regimens, and absence of formal GERD investigations are limitations of the study. Extending the
analysis to additional patients is expected to provide useful insight into PPI effects in EoE.
Biography
Seema Khan is a pediatric gastroenterologist in Washington, District of Columbia and is affiliated with multiple hospitals in the area, including Children's National Medical
Center and MedStar Georgetown University Hospital. She received her medical degree fromAga Khan Medical College and has been in practice for more than 20 years.
Dr. Khan accepts several types of health insurance, listed below. She is one of 14 doctors at Children's National Medical Center and one of 14 at MedStar Georgetown
University Hospital who specialize in Pediatric Gastroenterology.
Seema Khan, J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C3-070