Risk of developing eosinophilic esophagitis with preexisting asthma, allergic rhinitis, atopic dermatitis, or food allergy.

Background: Eosinophilic esophagitis (EoE) prevalence has been increasing in recent years and is associated with other atopic conditions. The association between EoE and the different atopic conditions is not well characterized. Objective: The objective was to assess the probability of developing EoE given different atopic conditions. Methods: Our retrospective cohort study used a de-identified electronic database of patient information to identify pediatric patients diagnosed with asthma, allergic rhinitis, atopic dermatitis, or food allergy. We ran separate analyses for each atopic condition and compared the probability of developing EoE with a control group that consisted of patients who had any diagnosis but without the one atopic diagnosis being studied. Cases and controls were matched for demographic factors and other atopic conditions. We contrasted the 3-year probability for developing EoE between matched cohorts and calculated the hazard ratios (HR) to quantify this interaction. Results: All studied atopic conditions studied were associated with an increased probability of developing EoE. Food allergy had the highest risk of developing EoE (HR 9.46 [95% confidence interval {CI}, 7.33-12.21]), followed by asthma (HR 4.11 [95% CI, 3.53-4.78]) and atopic dermatitis (HR 2.98 [95% CI, 2.42-3.67]), and was lowest for allergic rhinitis (HR 2.57 [95% CI, 2.21-3.00]). Conclusion: All atopic conditions, especially food allergy and asthma, were associated with an increased risk of developing EoE, which further supports the overlap among the different atopic diatheses.