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Peer-reviewedCC BY 4.0Jornal de Pediatria

Eosinophilic esophagitis in pediatrics: advances in diagnosis, treatment, and follow-up

  • Cristina Targa Ferreira1
  • Elisa de Carvalho1
  • Carlos M. Timossi2,3
  • Luciana Rodrigues Silva1
  • Marise Helena Cardoso Tofoli1
  • Maria do Carmo Barros de Melo1
  • Jackeline de Motta Franco1,4
  • Lucila Camargo Lopes de Oliveira1,4
  • Renata Rodrigues Cocco4
  • Herberto José Chong-Neto1,4
  • Dirceu Solé1,4,5
5 affiliations
  1. 1Brazilian Society of Pediatrics (SBP), Brazil
  2. 2Miramar MedCom, Department of Research and Development, Mexico City, Mexico
  3. 3Latin American Society of Pediatric Gastroenterology, Hepatology and Nutrition, Mexico City, Mexico
  4. 4Brazilian Association of Allergy and Immunology (ASBAI), Brazil
  5. 5Instituto Pensi, São Paulo, SP, Brazil
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Abstract

Objective: To identify the evidence and recommendations regarding pediatric eosinophilic esophagitis (EoE), including its diagnosis, treatment, and follow-up.

Sources: Narrative review based on a comprehensive and structured search of the MEDLINE (PubMed), EMBASE (Ovid), LILACS, and SciELO databases using the terms “diagnosis” OR “clinical manifestations” OR “treatment” OR “follow-up” AND “eosinophilic esophagitis” AND “children” through March 2026. Data obtained from the Brazilian Consensus (Brazilian Society of Pediatrics/Brazilian Association of Allergy and Immunology) were incorporated.

Summary of the findings: EoE is a chronic and emerging disease, and a significant cause of esophageal dysfunction. Early and accurate diagnosis is fundamental to avoid complications, such as fibrostenotic sequelae. Treatment can be performed with proton pump inhibitors, topical corticosteroids, and empirical diets, chosen according to clinical profile, adherence, and socioeconomic context. In refractory cases, dupilumab is an effective option. Allergy tests should not guide elimination diets. Endoscopic follow-up with biopsies is essential for evaluating response and maintenance, as the relapse rate is high, even in asymptomatic patients. Reassessment intervals should be individualized, but post-induction control between 8 and 12 weeks and periodic reviews during maintenance are recommended.

Conclusions: The dissociation between symptoms and histological inflammation represents one of the greatest clinical challenges, in addition to the heterogeneity of therapeutic response and limitations of long-term studies. Changes in follow-up and treatment algorithms are expected, especially with the inclusion of dupilumab. The Brazilian consensus represents an attempt to standardize diagnostic criteria, approach, and treatment.

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Cite

BibTeXRIS
BibTeX
@article{ferreira2026eosinophilic,
  title = {{Eosinophilic esophagitis in pediatrics: advances in diagnosis, treatment, and follow-up}},
  author = {Cristina Targa Ferreira and Elisa de Carvalho and Carlos M. Timossi and Luciana Rodrigues Silva and Marise Helena Cardoso Tofoli and Maria do Carmo Barros de Melo and Jackeline de Motta Franco and Lucila Camargo Lopes de Oliveira and Renata Rodrigues Cocco and Herberto José Chong-Neto and Dirceu Solé},
  journal = {Jornal de Pediatria},
  year = {2026},
  month = oct,
  doi = {10.1016/j.jped.2026.101635},
  url = {https://doi.org/10.1016/j.jped.2026.101635},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Eosinophilic esophagitis in pediatrics: advances in diagnosis, treatment, and follow-up
AU  - Cristina Targa Ferreira
AU  - Elisa de Carvalho
AU  - Carlos M. Timossi
AU  - Luciana Rodrigues Silva
AU  - Marise Helena Cardoso Tofoli
AU  - Maria do Carmo Barros de Melo
AU  - Jackeline de Motta Franco
AU  - Lucila Camargo Lopes de Oliveira
AU  - Renata Rodrigues Cocco
AU  - Herberto José Chong-Neto
AU  - Dirceu Solé
PY  - 2026
DA  - 2026/10/29
JO  - Jornal de Pediatria
DO  - 10.1016/j.jped.2026.101635
UR  - https://doi.org/10.1016/j.jped.2026.101635
AB  - Objective: To identify the evidence and recommendations regarding pediatric eosinophilic esophagitis (EoE), including its diagnosis, treatment, and follow-up.  Sources: Narrative review based on a comprehensive and structured search of the MEDLINE (PubMed), EMBASE (Ovid), LILACS, and SciELO databases using the terms “diagnosis” OR “clinical manifestations” OR “treatment” OR “follow-up” AND “eosinophilic esophagitis” AND “children” through March 2026. Data obtained from the Brazilian Consensus (Brazilian Society of Pediatrics/Brazilian Association of Allergy and Immunology) were incorporated.  Summary of the findings: EoE is a chronic and emerging disease, and a significant cause of esophageal dysfunction. Early and accurate diagnosis is fundamental to avoid complications, such as fibrostenotic sequelae. Treatment can be performed with proton pump inhibitors, topical corticosteroids, and empirical diets, chosen according to clinical profile, adherence, and socioeconomic context. In refractory cases, dupilumab is an effective option. Allergy tests should not guide elimination diets. Endoscopic follow-up with biopsies is essential for evaluating response and maintenance, as the relapse rate is high, even in asymptomatic patients. Reassessment intervals should be individualized, but post-induction control between 8 and 12 weeks and periodic reviews during maintenance are recommended.  Conclusions: The dissociation between symptoms and histological inflammation represents one of the greatest clinical challenges, in addition to the heterogeneity of therapeutic response and limitations of long-term studies. Changes in follow-up and treatment algorithms are expected, especially with the inclusion of dupilumab. The Brazilian consensus represents an attempt to standardize diagnostic criteria, approach, and treatment.
SN  - 0021-7557
SN  - 1678-4782
ER  -