A modified PEESSv2.0 survey was used to screen 189 pediatric patients (ages 3–17) with asthma in a tertiary care allergy clinic for eosinophilic esophagitis (EoE); those screening positive were referred to gastroenterology, with endoscopy when indicated.
EoE was diagnosed in 8 of 24 children who underwent endoscopy (33%); projected EoE prevalence in the asthma clinic population was **8.0%** (95% CI 5.1%–11.7%), rising to **13.9%** (95% CI 10.1%–18.4%) when accounting for nonparticipants and those lost to follow-up. Vomiting was the only individual symptom significantly associated with EoE diagnosis (P = .001); 75% of diagnosed patients identified as non-White.
- Large drop-off at each step (only 24/152 screen-positive patients reached endoscopy), limiting diagnostic yield estimates. - Single tertiary care center cohort may not reflect community asthma populations. - High screen-positive rate (80.4%) suggests low specificity of the modified PEESSv2.0 in this atopic population.
Consider routine EoE symptom screening (e.g., modified PEESSv2.0) in pediatric asthma clinics, especially when vomiting is reported, to catch EoE early and reduce fibrostenotic complications. This approach may also help close diagnostic gaps in non-White pediatric patients.
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