Celiac Disease and Eosinophilic Esophagitis in Children

Celiac disease is a chronic, Th1- type immune-mediated disorder, characterized by small intestinal inflammation and villous atrophy, which leads to malabsorption of nutrients,after the ingestion of gluten or related proteins from rye and barley by genetically susceptible individuals. Exclusion of offending food antigens results in disease remission and reexposure leads to recurrence. Extraintestinal manifestations have been associated with celiac disease in children and adults. Eosinophilic esophagitis is a chronic, Th2- type immune-mediated disorder, isolated to the esophagus, which is most often triggered by exposure to food antigens in children and aeroallergens in adults. During the last decade, the increasing prevalence of celiac disease and eosinophilic esophagitis has been recognized in pediatric and adult populations all over the world. Case series have suggested an association between eosinophilic esophagitis and celiac disease. The prevalence of eosinophilic esophagitis in subjects with celiac disease was about 10-times that of the general population. The aim of this review is to analyse the similarity between these two frequent associated conditions. Coexistent eosinophilic esophagitis should be considered in children with celiac disease who have persistent esophageal symptoms.