The Seasonality of Eosinophilic Esophagitis Flares in Children and Adolescents in Arizona

Abstract

Aeroallergens are implicated in the pathogenesis of eosinophilic esophagitis, which has a recurrent or relapsing nature. We aim to determine the incidence of seasonal disease recurrence, referred to as flares, of eosinophilic esophagitis in patients in Arizona with eosinophilic esophagitis in remission, and to characterize the presence of allergy and other disease co‐morbidities in patients that experience disease flare. A retrospective study was performed by analyzing data from visits of patients aged 5 to 18 years coded for eosinophilic esophagitis in remission seen by the Phoenix Children’s Hospital Pediatric Gastroenterology Department between June 2010 and June 2011. The data included 148 patients and 326 clinical visits. Data identified demographic information, allergy, and other disease co‐morbidities. Arizona seasons were defined as: spring from February 15 to June 15, and fall from September 1 to November 30, according to the typical pattern of allergen pollination. To analyze incidence and season of flares, statistical methods used included the Chi‐square tests and logistic regressions. Ninety‐four of 148 patients (63.5%) flared during the study period. An increased incidence of flares in the fall compared with other seasons was statistically significant (p = 0.041). Flares in the spring also had an increased incidence. Of the 94 patients that flared, 70 patients (74.5%) had environmental allergy, 83 (88.3%) had food allergy, and 66 (70.2%) had both environmental and food allergy. Our findings suggest a role for seasonal environmental allergens in the pathogenesis of eosinophilic esophagitis and disease flares in children in Arizona, particularly those with food allergy, environmental allergy, or both.