Be on the lookout for failure to thrive among pediatric patients with eosinophilic esophagitis, according to a letter to the editor of Annals of Allergy, Asthma & Immunology by Dr. Brenda Paquet of Sainte-Justine University Hospital Center in Montreal, and her colleagues.
These investigators reviewed charts for all children referred to their allergy clinic with a diagnosis of eosinophilic esophagitis (EoE) from 2004 to 2012. In addition to a standard clinical evaluation, patients had undergone a series of food and respiratory skin prick tests and food patch testing. Dr. Paquet and her associates also reviewed anthropometric measurements for the children and applied failure to thrive (FTT) criteria to all growth parameters available from birth.
Of 62 patients referred to the clinic, 15 (24%) met at least one of the six criteria for FTT, and more than half (n = 8) met at least two criteria. The most frequent FTT criterion met was a weight deceleration crossing two major percentile lines.
FTT should be assessed through different growth characteristics, such as weight, length, growth velocity, and body mass index, Dr Paquet and her associates wrote. “Because no single clinical feature can accurately predict it, it is important to maintain a high level of suspicion for FTT in children with a confirmed or suspected diagnosis of EoE, and inversely, EoE should be included in the differential diagnosis of FTT.” Although FTT usually resolves, it can persist in some children despite medical treatment, “highlighting the need for research and new therapies.”
Read the article in Annals of Allergy, Asthma & Immunology (2016 Jan. doi: 10.1016/j.anai.2015.09.015).