Caracterización epidemiológica, clínica y diagnóstica de niños con gastroenteropatía eosinofílica. Estudio retrospectivo de tres instituciones de salud de alta complejidad
Abstract:Antecedentes: Los desórdenes gastrointestinales eosinofílicos son poco frecuentes. En Colombia no hay estudios en población pediátrica.Objetivo: Describir características epidemiológicas, clínicas y diagnósticas de una población pediátrica con desórdenes gastrointestinales eosinofílicos.Métodos: Estudio observacional, retrospectivo en niños entre 0 y 12 años evaluados en tres hospitales de alta complejidad de Medellín, Colombia, entre 2010 y 2015.Resultados: De 151 niños, 74 (49 %) padecían esofagitis eosinofí… Show more
“…In retrospective studies without controls, all types of elimination diets, systemic and topical steroids were associated with clinical improvement in the majority of patients (7). This was also evident in several case reports of children treated with elimination diets or systemic steroids (11,13,98). When symptoms are suggestive of upper GI tract involvement, such as vomiting and nausea, treatment options include PPIs (7,13).…”
Section: Eoe Egids? Statement 32 There Is Lack Of Randomized Controll...mentioning
confidence: 87%
“…This was also evident in several case reports of children treated with elimination diets or systemic steroids (11,13,98). When symptoms are suggestive of upper GI tract involvement, such as vomiting and nausea, treatment options include PPIs (7,13). When symptoms are characterized by diarrhea and blood in the stool, treatment options include 5‐ASA (7).…”
Section: Statements Summary Of Evidence and Recommendationsmentioning
confidence: 99%
“…Coexisting allergic conditions are reported more frequently in patients with EoG (7,9,14). In a retrospective observational study of children aged 0-12 years from Colombia, gastric mucosal eosinophilia was thought to be secondary to food allergy, with the most sensitizing foods being egg, milk, shrimp, wheat, and chicken (13). Caldwell et al found that 7 of 14 patients diagnosed with EoG tested positive for foods or aeroallergens with skin prick tests (30).…”
INTRODUCTION:
Eosinophilic Gastrointestinal Disorders beyond Eosinophilic Esophagitis (non-EoE EGIDs) are rare chronic inflammatory disorders of the gastrointestinal (GI) tract. Diagnosis is based on clinical symptoms and histologic findings of eosinophilic inflammation after exclusion of a secondary cause or systemic disease. Currently, no guidelines exist for the evaluation of non-EoE EGIDs. Therefore, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) formed a task force group to provide consensus guidelines for childhood non-EoE EGIDs.
METHODS:
The working group was composed of pediatric gastroenterologists, adult gastroenterologists, allergists/immunologists, and pathologists. An extensive electronic literature search of the MEDLINE, EMBASE, and Cochrane databases was conducted up to February 2022. General methodology was used in the formulation of recommendations according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to meet current standards of evidence assessment.
RESULTS:
The guidelines provide information on the current concept of non-EoE EGIDs, disease pathogenesis, epidemiology, clinical manifestations, diagnostic and disease surveillance procedures, and current treatment options. Thirty-four statements based on available evidence and 41 recommendations based on expert opinion and best clinical practices were developed.
CONCLUSION:
Non-EoE EGIDs literature is limited in scope and depth, making clear recommendations difficult. These consensus-based clinical practice guidelines are intended to assist clinicians caring for children affected by non-EoE EGIDs and to facilitate high-quality randomized controlled trials of various treatment modalities using standardized, uniform disease definitions.
“…In retrospective studies without controls, all types of elimination diets, systemic and topical steroids were associated with clinical improvement in the majority of patients (7). This was also evident in several case reports of children treated with elimination diets or systemic steroids (11,13,98). When symptoms are suggestive of upper GI tract involvement, such as vomiting and nausea, treatment options include PPIs (7,13).…”
Section: Eoe Egids? Statement 32 There Is Lack Of Randomized Controll...mentioning
confidence: 87%
“…This was also evident in several case reports of children treated with elimination diets or systemic steroids (11,13,98). When symptoms are suggestive of upper GI tract involvement, such as vomiting and nausea, treatment options include PPIs (7,13). When symptoms are characterized by diarrhea and blood in the stool, treatment options include 5‐ASA (7).…”
Section: Statements Summary Of Evidence and Recommendationsmentioning
confidence: 99%
“…Coexisting allergic conditions are reported more frequently in patients with EoG (7,9,14). In a retrospective observational study of children aged 0-12 years from Colombia, gastric mucosal eosinophilia was thought to be secondary to food allergy, with the most sensitizing foods being egg, milk, shrimp, wheat, and chicken (13). Caldwell et al found that 7 of 14 patients diagnosed with EoG tested positive for foods or aeroallergens with skin prick tests (30).…”
INTRODUCTION:
Eosinophilic Gastrointestinal Disorders beyond Eosinophilic Esophagitis (non-EoE EGIDs) are rare chronic inflammatory disorders of the gastrointestinal (GI) tract. Diagnosis is based on clinical symptoms and histologic findings of eosinophilic inflammation after exclusion of a secondary cause or systemic disease. Currently, no guidelines exist for the evaluation of non-EoE EGIDs. Therefore, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) formed a task force group to provide consensus guidelines for childhood non-EoE EGIDs.
METHODS:
The working group was composed of pediatric gastroenterologists, adult gastroenterologists, allergists/immunologists, and pathologists. An extensive electronic literature search of the MEDLINE, EMBASE, and Cochrane databases was conducted up to February 2022. General methodology was used in the formulation of recommendations according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to meet current standards of evidence assessment.
RESULTS:
The guidelines provide information on the current concept of non-EoE EGIDs, disease pathogenesis, epidemiology, clinical manifestations, diagnostic and disease surveillance procedures, and current treatment options. Thirty-four statements based on available evidence and 41 recommendations based on expert opinion and best clinical practices were developed.
CONCLUSION:
Non-EoE EGIDs literature is limited in scope and depth, making clear recommendations difficult. These consensus-based clinical practice guidelines are intended to assist clinicians caring for children affected by non-EoE EGIDs and to facilitate high-quality randomized controlled trials of various treatment modalities using standardized, uniform disease definitions.
“…La duodenitis eosinofílica en este estudio estuvo presente en 1 paciente que tuvo como síntoma principal la no ganancia de peso; dato también descrito por otros autores (37,38) y que aparentemente pueden responder adecuadamente al montelukast (39). Otros síntomas digestivos en niños con duodenitis eosinofílica son el dolor abdominal y la diarrea (37,38).…”
Section: Giardiasis H Pylori Y Baja Tallaunclassified
“…La duodenitis eosinofílica en este estudio estuvo presente en 1 paciente que tuvo como síntoma principal la no ganancia de peso; dato también descrito por otros autores (37,38) y que aparentemente pueden responder adecuadamente al montelukast (39). Otros síntomas digestivos en niños con duodenitis eosinofílica son el dolor abdominal y la diarrea (37,38). A nivel del duodeno, los cambios histopatológicos reportados en este grupo de niños son la microerosión y la fibrosis (40), sin que los biomarcadores sean pruebas diagnósticas a considerar en ellos comúnmente (41).…”
Section: Giardiasis H Pylori Y Baja Tallaunclassified
Introducción: en el estudio de la baja talla de origen digestivo en niños no hay un patrón de paraclínicos preestablecido; sin embargo, la endoscopia de vías digestivas puede ser una herramienta útil para tal fin.
Objetivo: reportar una serie de casos de niños con diagnóstico de baja talla a quienes se les indicó una endoscopia de vías digestivas altas como parte de su estudio.
Reporte de casos: se incluyeron 15 niños entre los 2 y 16 años de edad, 53,3 % niñas, 26,7 % desnutridos según el índice de masa corporal y la talla para la edad, 66,7% con baja talla grave y 33,3% con baja talla moderada. El 53,3 % presentó dolor abdominal, el 46,7 % no tuvo ganancia de peso, el 26,7 % tuvo inapetencia y el 13,3 % tuvo vómito, entre otros. Entre el 40,0 % y el 93,4 % presentaron macro- o microscópicamente esofagitis, gastritis y duodenitis. Los hallazgos microscópicos más importantes fueron duodenitis crónica con giardiasis, úlceras duodenales, hiperplasia nodular linfoide duodenal, Helicobacter pylori y duodenitis crónica eosinofílica.
Conclusiones: a pesar de que la endoscopia de vías digestivas es un método poco utilizado y no bien descrito en el estudio de niños con baja talla, este reporte de casos describe organicidad en un 80,0 % de los niños analizados.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.