PMID- 38451662
OWN - NLM
STAT- MEDLINE
DCOM- 20240308
LR  - 20240308
IS  - 1678-4219 (Electronic)
IS  - 0004-2803 (Linking)
VI  - 61
DP  - 2024
TI  - ACCURACY OF THE EOSINOPHILIC ESOPHAGITIS ENDOSCOPIC REFERENCE SCORE IN CHILDREN.
PG  - e23103
LID - S0004-28032024000100200 [pii]
LID - 10.1590/S0004-2803.24612023-103 [doi]
AB  - BACKGROUND: To assess the efficacy of applying the endoscopic reference score for 
      EoE (EREFS) in children with symptoms of esophageal dysfunction naive to proton 
      pump inhibitor (PPI) therapy. METHODS: An observational cross-sectional study was 
      conducted by reviewing reports and photographs of upper gastrointestinal 
      endoscopies (UGE) and esophageal biopsies of patients with symptoms of esophageal 
      dysfunction. Patients who were treated with PPI or had other conditions that may 
      cause esophageal eosinophilia were excluded. RESULTS: Of the 2,036 patients 
      evaluated, endoscopic findings of EoE were identified in 248 (12.2%) and more 
      than one abnormality was observed in 167 (8.2%). Among all patients, 154 (7.6%) 
      presented esophageal eosinophilia (>/=15 eosinophils per high power field) 
      (P<0.01). In this group, 30 patients (19.5%) had normal endoscopy. In patients 
      with EoE, edema (74% vs 6.5%, P<0.01) and furrows (66.2% vs 2.4%, P<0.01) were 
      more prevalent than in the control group. Association of edema and furrows was 
      more frequent in patients with EoE than in the control group (29.2% vs 1.6%, 
      P<0.01, OR=24.7, CI=15.0-40.5). The presence of more than one endoscopic finding 
      had sensitivity of 80.5%, specificity of 93.4%, positive predictive value (PPV) 
      of 50%, negative predictive value (NPV) of 98.3%, and accuracy of 92.4%. 
      CONCLUSION: In conclusion, this study showed that endoscopic features suggestive 
      of EoE had high specificity and NPV for diagnosing EoE in children naive to PPI 
      therapy. These findings highlight the importance of the EREFS in contributing to 
      early identification of inflammatory and fibrostenosing characteristics of EoE, 
      making it possible to identify and to avoid progression of the disease. 
      BACKGROUND: * The EoE endoscopic reference score (EREFS) was developed and 
      validated in adults and has been demonstrated to be an adequate tool for 
      diagnosing and assessing treatment response in children. BACKGROUND: * The 
      presence of more than one endoscopic finding stronglysuggests EoE. BACKGROUND: * 
      The EoE endoscopic reference score presents high specificity and negative 
      predictive value for diagnosing EoE in children naive to proton pump inhibitor 
      (PPI) therapy. BACKGROUND: * Endoscopic findings suggestive of EoE in patients 
      naive to treatment may be useful to characterize disease phenotype and 
      individualize treatment according to the initial clinical presentation.
FAU - Ribeiro, Luciana M
AU  - Ribeiro LM
AUID- ORCID: 0000-0001-9643-2593
AD  - Hospital Pequeno Principe, Centro de Gastroenterologia Pediatrica, Curitiba, PR, 
      Brasil.
AD  - Pontificia Universidade Catolica do Parana, Faculdade de Medicina, Curitiba, PR, 
      Brasil.
FAU - Vieira, Mario C
AU  - Vieira MC
AUID- ORCID: 0000-0003-3405-2995
AD  - Hospital Pequeno Principe, Centro de Gastroenterologia Pediatrica, Curitiba, PR, 
      Brasil.
AD  - Pontificia Universidade Catolica do Parana, Faculdade de Medicina, Curitiba, PR, 
      Brasil.
FAU - Truppel, Sabine K
AU  - Truppel SK
AUID- ORCID: 0000-0001-9385-8310
AD  - Hospital Pequeno Principe, Centro de Gastroenterologia Pediatrica, Curitiba, PR, 
      Brasil.
FAU - Rosario Filho, Nelson A
AU  - Rosario Filho NA
AUID- ORCID: 0000-0002-8550-8051
AD  - Universidade Federal do Parana, Departamento de Pediatria, Curitiba, PR, Brasil.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20240304
PL  - Brazil
TA  - Arq Gastroenterol
JT  - Arquivos de gastroenterologia
JID - 15310600R
RN  - 0 (Proton Pump Inhibitors)
RN  - Eosinophilic enteropathy
SB  - IM
MH  - Child
MH  - Humans
MH  - Cross-Sectional Studies
MH  - Edema
MH  - Endoscopy
MH  - *Enteritis
MH  - *Eosinophilia
MH  - *Eosinophilic Esophagitis/diagnosis/drug therapy
MH  - *Gastritis
MH  - Proton Pump Inhibitors/therapeutic use
EDAT- 2024/03/07 12:42
MHDA- 2024/03/08 06:43
CRDT- 2024/03/07 11:55
PHST- 2023/07/14 00:00 [received]
PHST- 2023/10/06 00:00 [accepted]
PHST- 2024/03/08 06:43 [medline]
PHST- 2024/03/07 12:42 [pubmed]
PHST- 2024/03/07 11:55 [entrez]
AID - S0004-28032024000100200 [pii]
AID - 10.1590/S0004-2803.24612023-103 [doi]
PST - epublish
SO  - Arq Gastroenterol. 2024 Mar 4;61:e23103. doi: 10.1590/S0004-2803.24612023-103. 
      eCollection 2024.