Table 4.
Clinical diagnosis, treatment and follow-up of up to 4 years
| Case | Pre-treatment clinical diagnosis (after biopsy) | Treatment and follow-up (2009–2011) | Final clinical diagnosis |
| 1 | EO | Initial histological response to anti-IL-5 for up to 6 months but then rebound EO warranting treatment with 6 weeks of exclusive elemental feed with good clinical and histological response. Symptoms have now rebound and currently on introduction of dietary protein. Feed aversive behaviour. Atopy. | EO |
| 2 | EO | Initial clinical and histological response to egg-, wheat-, banana- and nut-free diet. However, with worsening asthma, his symptoms have re-surfaced, i.e., vomiting and low appetite with some clinical response to leucotriene receptor antagonist. | EO |
| 3 | EO | Exclusion diet. Gradual improvement of symptoms and at discharged from care at 2 years. | EO |
| 4 | EO + GORD (OS) | Clinical improvement in symptoms with long-term PPI and domperidone at 2-year follow-up was gradually being weaned off PPI at 2-year follow-up. | GORD (OS) |
| 5 | EO | Short-term PPI and gradually weaned off by 1 year of age. | GORD (OS) |
| 6 | EO | Some clinical response to dairy-free diet but then went onto develop feed aversive behaviour and slow transit constipation on follow-up at 2 years. Parents not keen on re-assessment scope as dietary restriction very difficult due to behavioural difficulties. | EO |
| 7 | EO + GORD (OS) | Had a gastrostomy. With improvement in nutrition and weight gain, significant improvement in asthma and gastrointestinal symptoms and discharged from care at 2-year follow-up. | EO |
| 8 | EO + GORD (OS) | PPI treatment for 6 months with resolution of symptoms. | GORD (OS) |
| 9 | EO +GORD (OS) | Initial clinical response to 6-week elemental feed regime and gradual reintroduction of proteins in diet over 3 months. Kept on PPI for 1 year and weaned off by 2nd year. No gastrointestinal or respiratory symptoms at 2-year follow-up. | GORD (OS) |
| 10 | EO + GORD (OS) | Stayed on PPI with partial control of symptoms and care then transferred to adult gastroenterologist. | GORD (OS) |
| 11 | EO | Given a trial of PPI with no improvement in symptoms of vomiting, feed aversion and eczema. Then found to have multiple food allergies on RAST testing. At 6 months of age, put on six protein-free diet (milk, soya, egg, nuts, fish and wheat) with complete resolution of symptoms by 9 months. On reintroduction was symptomatic with milk, soya, eggs and wheat but asymptomatic with other nuts and fish. Discharged from gastro follow-up at 14 months. | EO |
| 12 | EO | EO identified at the time of gastrostomy insertion along with significant acid reflux. Trial of PPI had some improvement but no resolution. Later Neocate and dairy/soya-free diet with both clinical and histological resolution at 9 months post-diagnosis. She then went into adoption and care was transferred. | GORD (OS) |
| 13 | EO + GORD (OS) | Persistence of symptoms despite of topical steroids. At 2-year follow-up, was commenced on oral steroids and had a clinical response to his dysphagia. | EO |
| 14 | EO | Subsequently developed eosinophilic gastroenteritis. Excellent response to dairy-free diet on follow-up. | Eosinophilic gastroenteritis |
| 15 | EO | Initial poor response to topical budesonide. Subsequently symptomatic improvement on six protein elimination diet. | EO |
| 16 | EO | Partial response to PPI but had PEG inserted during the same procedure. After 6-week trial of PPI, went onto Neocate (elemental feed) for 6 weeks. At 18 months dairy and soya reintroduced in diet with tolerance. | EO |
| 17 | EO + GORD (OS) | Lost to follow-up. | |
| 18 | EO + GORD (OS) | Partial response to PPI alone and then subsequently put on dairy-free diet with clinical improvement in symptoms. Gradually weaned off PPI and at 2 years back onto dairy with no recurrence of symptoms. | GORD (OS) |
| 19 | EO | Subsequently developed eosinophilic gastroenteritis. Good response to dairy-, soya- and wheat-free diet. | Eosinophilic gastroenteritis |
| 20 | EO | Persistently positive coeliac serology. Re-scoped after 18 months on a gluten-containing diet with no evidence of coeliac disease but persistence of EO. Symptoms of pain did not improve on dairy- or wheat-free diet and was put on topical budesonide with some positive response. | EO |
| 21 | EO | No upper gastrointestinal I symptoms after histological diagnosis. Only had intermittent diarrhoea, which was subsequently diagnosed as having irritable bowel syndrome and responded well to Mebeverine and Loperamide. | Irritable bowel syndrome |
| 22 | EO + GORD (OS) | Initial lack of response to PPI and anti-histamine but at 2-year follow-up responded to dairy-free diet. | EO |
| 23 | EO | Improvement on dairy- and soya-free diet. Symptoms appear to be re-surfacing on reintroduction of soya. Due to a repeat endoscopy. | EO |
| 24 | EO | No improvement in symptoms on dairy-free diet and some response to topical budesonide gel. Lost to follow-up. | EO |
EO, eosinophilic oesophagitis; GORD, gastrooesophageal reflux disease; IL-5, interleukin 5; OS, overlap syndrome; PPI, proton pump inhibitor; RAST test, radioallergosorbent test.