Clinical, endoscopic, histological and radiological characteristics of Italian patients with eosinophilic oesophagitis

Savarino, Edoardo; Tolone, Salvatore; Caccaro, Roberta; Bartolo, Ottavia; Galeazzi, Francesca; Nicoletti, Loredana; Morbin, T.; Zanatta, Lucia; Salvador, Renato; Costantini, Mario

doi:10.1016/j.dld.2015.08.013

Cited by 11 publications

(10 citation statements)

References 40 publications

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“…Evidence relating to the clinical features and natural history of EoE was available in 27 publications on studies conducted in Australia, 25 Italy, 26 , 27 Japan, 28 Slovenia, 18 Spain, 29 Switzerland, 30 , 31 the UK, 23 and the USA (Table 1 ). 7 , 10 , 13 , 32–46 …”

Section: Resultsmentioning

confidence: 99%

“…5a ). 23 , 26 , 27 , 32 , 38 , 44 The average delay from symptom onset until diagnosis ranged from 1.2 to 3.5 years in children, from 3.0 to 8.0 years in adults, and from 2.5 to 6.8 years in populations that included both children and adults (Fig. 5b ).…”

Section: Resultsmentioning

confidence: 99%

“…This is the first systematic review to assess the disease course of EoE. The mean time from symptom onset to diagnosis of EoE was up to 3.5 years in children and 8.0 years in adults, 26 , 32 , 36–38 suggesting a need for a better understanding of the common symptoms and early indicators of the disease, which would enable clinicians to provide earlier diagnosis and therefore more effective treatment as well as making patients aware of a potential underlying disease.…”

Section: Discussionmentioning

confidence: 99%

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Natural history of eosinophilic esophagitis: a systematic review of epidemiology and disease course

Shaheen

Mukkada

Eichinger³

et al. 2018

Diseases of the Esophagus

110

111

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SUMMARYEosinophilic esophagitis is a chronic immune-mediated esophageal disorder. For its timely diagnosis, clinicians must recognize common symptoms, and understand differences in symptoms across patient groups. The aim of this study is to systematically review the epidemiology and natural history of eosinophilic esophagitis. The MEDLINE, Embase, and Cochrane databases were searched from 1974 to February 2017 for studies describing the epidemiology and natural history of eosinophilic esophagitis. Congress abstracts from 2014 to 2016 were also searched. Search results were screened against predetermined inclusion/exclusion criteria by two independent reviewers, and data extraction was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 1376 articles identified, 47 met the inclusion criteria: 20 on epidemiology and 27 on natural history. Incidence and prevalence of eosinophilic esophagitis varied widely across North America and Europe, and increased over time. Incidence increased 131-fold in the Netherlands (1996–2010), 20-fold in Denmark (1997–2006), and 5.1-fold in Calgary, Canada (2004–2008). The most commonly reported symptoms were emesis and abdominal pain in children, and dysphagia and food impaction in adults. Age at diagnosis was 5.9–12.0 years in children, and approximately 30 years in adults. Time between symptom onset and diagnosis was 1.2–3.5 years in children and 3.0–8.0 years in adults. Diagnostic delay was associated with an increased risk of endoscopic features of fibrostenosis. Symptoms of eosinophilic esophagitis differed significantly by age and race. In conclusion, there is an increasing incidence and prevalence of eosinophilic esophagitis. The considerable delay between symptom onset and diagnosis suggests that clinicians do not readily recognize the disease, which may have important clinical ramifications.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Natural history of eosinophilic esophagitis: a systematic review of epidemiology and disease course

Shaheen

Mukkada

Eichinger³

et al. 2018

Diseases of the Esophagus

110

111

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“…Распространенность ЭоЭ значительно различается у пациентов с различными симптомами: так, среди больных с рефрактерной изжогой ЭоЭ встречается нечасто (0,9-8%); у больных с некардиальной загрудинной болью -у 6%; у пациентов, жалующихся на затруднения при глотании и эпизоды вклинения пищи вероятность обнаружить ЭоЭ при проведении ЭГДС возрастает до 23-46% [43][44][45][46][47][48][49][50][51][52][53][54].…”

Section: эпидемиологияunclassified

The main statements of the European society of eosinophilic oesophagitis guidelines

Кайбышева¹,

Федоров²,

Mikhaleva³

et al. 2018

Dok. gastroenterol.

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Цель исследования-представить и обсудить основные положения новых рекомендаций Европейского общества по изучению эозинофильного эзофагита (ЭоЭ), опубликованные в 2017 г. Материал и методы. В последние годы изучение ЭоЭ достигло качественно нового уровня: были проведены и закончены крупные рандомизированные контролируемые исследования, опубликованы результаты систематических обзоров, показавшие необходимость пересмотра предшествующих рекомендаций с использованием принципов доказательной медицины. 16 октября 2016 г. в рамках 24-й Объединенной европейской гастроэнтерологической недели состоялось совещание экспертной рабочей группы по созданию новых рекомендаций по диагностике и лечению ЭоЭ. Каждый пункт рекомендаций был оценен по уровню доказательности (высокий, умеренный, низкий, очень низкий) и степени рекомендаций по отношению к применению или, наоборот, неприменению, которая могла быть сильной или слабой (применялось только для рекомендаций, относящихся к вопросам диагностики и лечения). Итогом работы экспертной рабочей группы стало создание рекомендаций по диагностике и лечению ЭоЭ у детей и взрослых (Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults). Заключение. Новые рекомендации по диагностике и лечению ЭоЭ у детей и взрослых, основанные на принципах доказательной медицины, позволяют оптимизировать диагностику заболевания, существенно улучшить результаты лечения больных, снизить риск осложнений. Ключевые слова: эозинофильный эзофагит, эозинофилия пищевода, ингибиторы протонной помпы.

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“…A apresentação clínica da EoE é variável, tendo como sintomas mais típicos disfagia intermitente com impactação alimentar, azia, dor retroesternal, regurgitações, dor abdominal, náuseas e vômitos (ATTWOOD et al, 1993;SAVARINO et al, 2015).…”

Section: Introductionunclassified

Aspectos histopatológicos da esofagite eosinofílica em crianças e adolescentes

Daud¹

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Introdução: Esofagite eosinofílica (EoE) é uma desordem clínico-patológica, caracterizada por sintomas de disfunção esofágica e alterações histopatológicas com inflamação composta principalmente por eosinófilos, sendo necessário, pelo último consenso, 15 ou mais eosinófilos/campo microscópico de grande aumento (cmga). Contudo, esse achado histopatológico geralmente está acompanhado de outras alterações morfológicas na mucosa esofágica que fazem parte do quadro de resposta inflamatória e que têm sido cada vez mais investigadas. Objetivos: Descrever achados histopatológicos em biópsias de pacientes pediátricos e adolescentes com EoE e compará-las aos de pacientes com quadro clínico de epigastralgia. Material e métodos: Foram analisadas biópsias esofágicas, sendo dezessete com diagnóstico de EoE e dezessete com epigastralgia. Analisaram-se aspectos histopatológicos e imuno-histoquímicos, como número máximo de eosinófilos, alongamento das papilas, hiperplasia de células da camada basal, espaços intercelulares, microabscessos e expressão de CD1a. Resultados: Entre os achados histopatológicos, alongamento das papilas e hiperplasia da camada basal foram observados em todos os participantes com EoE e em nenhuma amostra do grupo epigastralgia. Aumento do espaço intercelular foi encontrado em todos os pacientes com EoE e em 29,41% dos pacientes com epigastralgia. Conclusões: A quantidade de eosinófilos pode não mostrar por si só a complexidade da EoE. Estudos futuros devem ser realizados tentando definir se algum achado morfológico pode ajudar no diagnóstico diferencial entre EoE e eosinofilia esofágica responsiva ao inibidor de bomba de prótons e se poderiam ser utilizados para acompanhamento da eficácia do tratamento da EoE.

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Clinical, endoscopic, histological and radiological characteristics of Italian patients with eosinophilic oesophagitis

Cited by 11 publications

References 40 publications

Natural history of eosinophilic esophagitis: a systematic review of epidemiology and disease course

Natural history of eosinophilic esophagitis: a systematic review of epidemiology and disease course

The main statements of the European society of eosinophilic oesophagitis guidelines

Aspectos histopatológicos da esofagite eosinofílica em crianças e adolescentes

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