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Vitamin deficiencies in pediatric eosinophilic esophagitis: A systematic review
Author(s) -
Fissinger Alexis,
Mages Keith C.,
Solomon Aliza B.
Publication year - 2020
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.13297
Subject(s) - eosinophilic esophagitis , medicine , vitamin d and neurology , cochrane library , systematic review , medline , pediatrics , vitamin d deficiency , disease , meta analysis , political science , law
Background Nutritional deficiencies are seen in patients with food allergy. Low vitamin D levels have been found in patients with atopic conditions. Eosinophilic esophagitis (EoE) is a chronic immune antigen‐mediated disease found to be highly associated in patients with atopic disease and treated with dietary elimination with recommendations to utilize a dietician to prevent nutritional deficiencies. Nonetheless, the relationship between EoE and vitamin deficiency remains unclear. We aimed to systematically review the evidence to support a possible association between vitamin deficiency and eosinophilic esophagitis. Methods Electronic searches were performed with keywords relating to EoE and vitamins among pediatric patients in MEDLINE, EMBASE, and The Cochrane Library. Summary estimates were calculated. Citations were reviewed against pre‐defined criteria. (Inclusion: human subjects, aged 0‐18, with eosinophilic esophagitis. Exclusion: adults over 18 years, non‐English papers). Results The search yielded 1707 studies. Five of these studies with a total of 137 pediatric patients were included in the systematic review. Outcome measures were assessed at different points in EoE treatment across studies. The single common outcome measure across all included studies was vitamin D. Reported prevalence of low vitamin D varied in these studies (0%‐52%). Vitamin D levels of children with EoE both pre‐ and post‐intervention were low. Conclusions There is limited published literature on vitamin deficiencies associated with EoE both pre‐ and post‐intervention. The limited data on vitamin D suggest that insufficiency or deficiency may be present in these patients, but it remains unclear whether deficiency is caused by diet. More prospective, well‐defined studies, in addition to routine reporting on dietary intake and nutritional status, are needed to make any conclusions or recommendations for screening.