Eosinophilic Gastritis/Gastroenteritis

Chen, Phillip H.; Anderson, Lorraine; Zhang, Kuixing; Weiss, Guy A.

doi:10.1007/s11894-021-00809-2

Cited by 32 publications

(50 citation statements)

References 79 publications

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“…Unlike the oesophagus, eosinophils are a normal finding in other segments of the gastrointestinal tract and are believed to play a role in the mucosal immune response (15). Currently, the exact mechanism that underlies EGIDs is not completely understood, falling between a pure IgE-mediated and a delayed TH2-type response, which notably includes chemokines like eotaxin and cytokines like IL-5 (14). It seems to be related to several factors including genetic predisposition, environmental risk factors (such as food allergens), intestinal dysbiosis and impaired epithelial barrier (14,15).…”

Section: Eosinophilic Gastritismentioning

confidence: 99%

“…Currently, the exact mechanism that underlies EGIDs is not completely understood, falling between a pure IgE-mediated and a delayed TH2-type response, which notably includes chemokines like eotaxin and cytokines like IL-5 (14). It seems to be related to several factors including genetic predisposition, environmental risk factors (such as food allergens), intestinal dysbiosis and impaired epithelial barrier (14,15). Activated eosinophils infiltrate the tissues, release cytotoxic granules, and induce an inflammatory response causing damage to the involved intestinal layer (14).…”

Section: Eosinophilic Gastritismentioning

confidence: 99%

“…It seems to be related to several factors including genetic predisposition, environmental risk factors (such as food allergens), intestinal dysbiosis and impaired epithelial barrier (14,15). Activated eosinophils infiltrate the tissues, release cytotoxic granules, and induce an inflammatory response causing damage to the involved intestinal layer (14).…”

Section: Eosinophilic Gastritismentioning

confidence: 99%

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Helicobacter pylori‐negative Chronic Gastritis in Children

Assa

Borrelli

Broekaert

et al. 2022

J. pediatr. gastroenterol. nutr.

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Objectives:To systematically review the current evidence on Helicobacter pylori-negative chronic gastritis including natural history, available therapies and outcomes.Methods:Articles providing data on the prevalence, treatment or outcomes of Helicobacter pylori-negative gastritis were identified through a systematic search in the MEDLINE and EMBASE databases. All original research articles from human studies until October 31, 2021, were included.Results:A total of 54 studies were included consisted of eosinophilic gastritis (n = 9), autoimmune gastritis (n = 11), collagenous gastritis (n = 16), focally enhanced gastritis (n = 6), lymphocytic gastritis (n = 5) and other causes including idiopathic gastritis and chronic renal failure related (n = 7). Most of the included studies were either cross-sectional or longitudinal cohorts except for collagenous gastritis, which mainly included case reports and case series. The prevalence of paediatric eosinophilic gastritis ranges between 5 and 7/100,000 and patients have generally favourable outcome with 50% to 70% clinical and histological response to either corticosteroids or elimination diets. Autoimmune gastritis and collagenous gastritis are extremely rare entities, commonly present with refractory iron deficiency anaemia, while lymphocytic gastritis is relatively common (10%–45%) in children with coeliac disease. Data on treatments and outcomes of autoimmune, collagenous, and focally enhanced gastritis are lacking with limited data implying poor response to therapy in the former 2 diagnoses.Conclusions:Helicobacter pylori-negative gastritis is uncommonly reported, mainly in small cohorts, mixed adult-paediatric cohorts or as sporadic case reports. As common symptoms are not specific, thus not always result in an endoscopic evaluation, the true prevalence of these distinct disorders may be underestimated, and thus under reported.

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Section: Eosinophilic Gastritismentioning

confidence: 99%

Section: Eosinophilic Gastritismentioning

confidence: 99%

Section: Eosinophilic Gastritismentioning

confidence: 99%

See 1 more Smart Citation

Helicobacter pylori‐negative Chronic Gastritis in Children

Assa

Borrelli

Broekaert

et al. 2022

J. pediatr. gastroenterol. nutr.

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“…Therapeutic algorithms suggest specific allergen avoidance as a first-line treatment and then, if not feasible or ineffective, glucocorticoid therapy, first topical and then systemic 61 . While some studies reported that dietary treatment alone may induce remission of symptoms 41 , 62 most of the time it is used in combination with corticosteroids 63 , leukotriene-receptor antagonists, mast-cell stabilisers, antihistamines, immunomodulators and biologics 64 . In daily practice corticosteroids remain the mainstay of treatment, although often requiring long-term use with its clinical consequences.…”

Section: Normal Distribution Of Eosinophils In the Gastrointestinal T...mentioning

confidence: 99%

Pathologist’s approach to paediatric and neonatal eosinophilic gastrointestinal disorders

et al. 2022

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Summary Children are not simply miniature adults. The evaluation of their gastrointestinal disorders is therefore different from that in full-grown adults and requires a particular clinical/pathologic approach. Different studies have tried to assess the normal eosinophil distribution in the gastrointestinal tract in adults while very few studies have investigated the paediatric population, consequently complicating the pathologist’s ability in identifying an abnormal number of eosinophils in this setting of patients. When evaluating gastrointestinal tract biopsies with eosinophilia, eosinophilic count must be considered along with other histological features like eosinophil distribution in the gastrointestinal wall, their degranulation, cryptitis and crypt abscesses, other accompanying inflammatory cells, apoptotic bodies, foreign material or microorganisms; these findings, although rarely specific, may be a useful aid for diagnosis. Reports should not include a diagnosis of primary eosinophilic gastrointestinal disorders (EoGID) if clinical data and test results do not rule out other forms of gastrointestinal eosinophilia. A more descriptive definition like “with eosinophilic pattern” should be favoured over a specific diagnosis of “eosinophilic disorder” in order to avoid potential confusion between different entities.

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“…The diagnosis of EGE is frequently delayed, mostly due to variable clinical picture, inconsistent correlation with histopathologic examination and the association of blood eosinophilia which needs exclusion of many other diseases [ 3 ]. Eosinophilic gastroenteritis (EGE) is considered a rare and heterogeneous disease, with a still unclear pathophysiologic mechanism beyond the eosinophilic involvement and no standardized diagnostic and therapeutic approach exists [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Follow-Up of a Rare Case of Eosinophilic Gastroenteritis Associated with Persistent Blood Eosinophilia and Multiple Food Allergies

et al. 2022

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Eosinophilic gastroenteritis (EGE) is a subgroup of the eosinophilic gastro-intestinal disorders (EGIDs), characterized by eosinophilic infiltration and chronic inflammation of the gastrointestinal tract. These are rare diseases with still incompletely elucidated causes and mechanisms, with frequently delayed diagnosis and variable outcome. Despite increased interest in eosinophilic diseases in recent years, fewer data have been published on EGE and no standardized diagnostic and therapeutic approach exists. This paper reports the case of a young male patient diagnosed with EGE in 2017 based on clinical and histopathological criteria and constantly monitored during five years. Besides gastrointestinal eosinophilic infiltration, biopsies also revealed eosinophilic infiltration of the oesophagus, despite no declared characteristic oesophageal symptoms. We found increased specific IgE to multiple foods and progressive blood hypereosinophilia which preceded EGE diagnosis by three years. The EGE management included selective dietary restrictions and pharmacologic therapy based on daily budesonide non-enteric coated tablets, proton pumps inhibitors, antihistamines, cromoglycate, correction of iron, calcium and vitamin D deficiencies. The clinical outcome was good, while blood eosinophilia and endoscopic appearance remained almost unchanged. After one year the patient complained of respiratory symptoms suggesting asthma, needing continuous combined inhaled therapy. The reported case is illustrative for complex presentation, diagnosis and outcome of a rare case of mucosal chronic EGE associated with oesophageal involvement, peripheral eosinophilia, multiple food allergies and asthma.

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Eosinophilic Gastritis/Gastroenteritis

Cited by 32 publications

References 79 publications

Helicobacter pylori‐negative Chronic Gastritis in Children

Helicobacter pylori‐negative Chronic Gastritis in Children

Pathologist’s approach to paediatric and neonatal eosinophilic gastrointestinal disorders

Follow-Up of a Rare Case of Eosinophilic Gastroenteritis Associated with Persistent Blood Eosinophilia and Multiple Food Allergies

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