Objective To analyze the clinical characteristics of pediatric eosinophilic gastrointestinal disorders beyond eosinophilic esophagitis (non⁃EoE EGID). Methods A retrospective analysis was conducted on the clinical data of 39 children diagnosed with non⁃EoE EGID based on the 2024 European Society for Paediatric Gastroenterology Hepatology and Nutrition Committee/the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (2024 ESPGHAN/NASPGHAN) diagnostic criteria. The data included general information, clinical manifestations, related medical history, laboratory findings, imaging results, endoscopic findings, histopathological findings, therapeutic regimens, and prognosis. According to treatment outcomes, children were divided into good prognosis group or poor prognosis group, and the clinical characteristics were compared between the two groups. Results Among the 39 children, 24 were boys (61.5%) and 15 were girls (38.5%), with an age of onset of 9.1 (8, 10.9) years. Common clinical symptoms included abdominal pain (89.7%), diarrhea (35.9%), and vomiting (33.3%). The main extra⁃gastrointestinal manifestations were malnutrition (33.3%) and anemia (20.5%). A history of allergic diseases/atopy was present in 16 cases (41.0%). Laboratory tests depicted elevated peripheral blood eosinophil (EOS) count in 13 cases (33.3%) and elevated total IgE level in 10 cases (25.6%). The most common endoscopic finding was congestion and edema (46.2%). Histopathological examination revealed single⁃site involvement in 84.6% of cases, with the ileum being the most frequently affected site (54.5%). Twenty⁃six children (66.7%) received non⁃glucocorticoid therapy, while 13 patients (33.3%) received glucocorticoid therapy. Twenty⁃nine children (the good prognosis group) were cured, with an overall cure rate of 74.4%. The treatment course was ≤8 weeks in 69.2% of children. The proportion of children with allergic diseases/atopy was higher in the poor prognosis group than in the good prognosis group (P<0.05). No statistically significant difference was found between the two groups in laboratory indicators, proportion of malnutrition, occurrence status of psychiatric disorders, endoscopic abnormalities, or multi⁃site involvement (P>0.05). Conclusion The clinical manifestations of pediatric non⁃EoE EGID are non⁃specific, and some children present with malnutrition and anemia. Most children have a favorable prognosis, while those with poor prognosis often have concomitant allergic diseases/atopy. Whether the 2024 ESPGHAN/NASPGHAN diagnostic criteria can be applied in China requires further investigation.  

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