Variable endoscopic and histological findings of esophageal lining are often detected in celiac disease, with unknown significance. We investigated the frequency and significance of such abnormalities in children. Macroscopic esophageal findings as reported by endoscopist and histological results by pathologist were compared between 316 celiac disease patients and 378 disease controls who had undergone upper gastrointestinal endoscopy with systematic esophageal biopsy sampling. Association between esophageal abnormalities and other clinical and histological characteristics of the disease was evaluated in celiac disease patients. Endoscopic esophageal findings were reported least often (3.8%) of all diseases in celiac disease, whereas histopathologic abnormalities were frequent (16.8%, n = 53). Children with celiac disease and esophageal histopathology reported more reflux than those with normal esophagus (5.7 vs. 0.8%, P = 0.032), whereas the groups were comparable in the frequency and severity of other symptoms, demographic data, prevalence of celiac disease-associated and other coexisting chronic conditions, family history of celiac disease, anthropometric and laboratory parameters, and degree of villous atrophy. Only 2 (3.7%) out of the 53 children with histologic findings had esophageal symptoms at diagnosis, and altogether seven were treated with acid blockers. Four children had increased number (≥15 eosinophils per high-power field) of esophageal eosinophils, but none of them had definite eosinophilic esophagitis. The remaining 45 children had only unspecific inflammation in the esophagus and reported no esophageal problems during a median of 6.9 years follow-up. To conclude, although relatively common, histopathological esophageal findings in celiac disease are mostly unspecific and without major clinical significance even in a long-term follow-up.

中文翻译：

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腹腔疾病患儿食管异常的患病率及其临床意义。

在腹腔疾病中经常发现食管内膜的内窥镜和组织学变化，其意义不明。我们调查了此类异常在儿童中的发生频率和重要性。内镜医师报告的宏观食管检查结果和病理学家的组织学结果在316例腹腔疾病患者和378例疾病对照者中进行了比较，这些患者接受了上消化道内镜检查并进行了系统性食管活检。在腹腔疾病患者中评估了食道异常与该疾病的其他临床和组织学特征之间的关联。腹腔疾病的所有疾病中，内镜食道检查的报道最少（3.8％），而组织病理学异常则很常见（16.8％，n = 53）。患有乳糜泻和食道组织病理学的儿童比正常食管的儿童报告的反流更多（5.7比0.8％，P = 0.032），而其他症状，人口统计学数据，与乳糜泻相关的患病率在两组中具有可比性和其他并存的慢性疾病，乳糜泻家族史，人体测量学和实验室参数以及绒毛萎缩程度。在有组织学发现的53名儿童中，只有2名（3.7％）在诊断时出现食道症状，总共有7名接受了酸阻滞剂治疗。四个孩子的食管嗜酸性粒细胞数量增加（每个高倍视野中≥15个嗜酸性粒细胞），但没有一个患上明确的嗜酸性食管炎。其余45名儿童在食道中仅出现非特异性炎症，在6.9年的中位随访期间未报告有食道问题。总而言之，尽管相对常见，但乳糜泻的组织病理学食管检查结果大多无特异性，即使在长期随访中也没有重大的临床意义。