Rapidly increasing prevalence of eosinophilic oesophagitis in Western Australia

Sarah Cherian ^1*, Nicholas Milton Smith ¹ and David Alan Forbes ¹

¹ Princess Margaret Hospital for Children, Australia

^* To whom correspondence should be addressed. E-mail: sarah.cherian{at}health.wa.gov.au.

Accepted 23 July 2006

Abstract

Aims: To assess the prevalence of eosinophilic oesophagitis in a tertiary paediatric gastroenterology clinic population.

Methods: A retrospective audit of Western Australian children investigated for oesophageal disease by paediatric gastroenterologists in the years 1995, 1999 and 2004. Macroscopic appearance of the oesophagus at endoscopy, original histological findings and diagnosis were recorded for each child. Biopsies were blindly re-evaluated, with re-coded histological diagnoses compared to original reports. Age, sex and socioeconomic status were identified for each child.

Results: The prevalence of eosinophilic oesophagitis in Western Australia increased over the decade 1995-2004, rising from 0.05/10 000 to 0.89/10 000 with a concomitant increase in severity of oesophagitis as determined by inflammatory cell numbers and associated features of inflammation. Children diagnosed with eosinophilic oesophagitis had a median age of 78.9 months (6.58 years) with no associated gender predisposition or socio-economic status trend. Almost one third of cases were macroscopically normal at endoscopy. All children with an original diagnosis of eosinophilic oesophagitis had 40 or more eosinophils per high power field examination.

Conclusion: Over a decade, there was a true increase in prevalence of eosinophilic oesophagitis, not accounted for by diagnostic shift. Histological samples should be taken at endoscopy in order to confirm or exclude the diagnosis of eosinophilic oesophagitis.

Keywords: eosinophils, epidemiology, oesophagitis, paediatrics, pathology

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