454:
Can Clinical History and Demographics Predict Low or Changing BMI in Children with Esophageal Eosinophilia?
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Tara Sarin, MD, William Bennett, Jr, MD, MS, Girish V. Vitalpur, MD, Emily Hon, MD
RATIONALE:

Eosinophilic esophagitis (EoE) is a food-antigen-mediated disease causing esophageal dysfunction and eosinophilia. Proton-pump inhibitor responsive esophageal eosinophilia (PPIREE) involves reduction in eosinophilia after an eight-week trial of a high-dose PPI. There are limited data on body mass index (BMI) in EoE and PPIREE, especially in children. Our aims were to evaluate BMI of esophageal eosinophilia patients over a multiyear period, and to assess the clinical characteristics of this population in relation to their BMI.

METHODS:

Charts of all patients with EoE and PPIREE in 2013-4 at a major children’s hospital were examined for: presenting symptoms and duration; initial treatment choice; biopsy findings; demographic data; BMI and food allergy evaluation. BMI percentiles were recorded at every encounter until December 2016. Logistic regression was performed using outcomes of BMI<10th percentile, and >10th percentile change in BMI over the follow-up period.

RESULTS:

Ninety-five patients were evaluated. Patients who presented with picky eating were more likely to have a BMI<10th percentile (p=0.049). Those 11y-14y, and 15y-18y, were less likely to have a greater than 10th percentile change in BMI, compared to those aged 2y-5y (p=0.021 and p=0.013, respectively). There were no other factors which predicted low or changing BMI over time. 49/95(51.6%) had had a food allergy evaluation. Of these 49, 15(30.6%) had a history of IgE-mediated reactions, and 18(36.7%) had sensitization only.

CONCLUSIONS:

Picky eating may be associated with lower BMI on presentation of children with esophageal eosinophilia. Larger prospective studies are needed to assess this symptom and other relationships between BMI and clinical characteristics.