Eosinophilic Gastritis in Children: Clinicopathological Correlation, Disease Course, and Response to Therapy

Ko, Huaibin M.; Morotti, Raffaella; Yershov, Oksana; Chehade, Mirna

doi:10.1038/ajg.2014.166

Cited by 162 publications

(161 citation statements)

References 19 publications

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“…For example, although an elemental diet or swallowed fluticasone may be appropriate for a patient with isolated eosinophilic esophagitis irrespective of AEC, 40,41 these therapies are unlikely to prevent progression of disease in multisystem HES.…”

Section: Myeloproliferative He/hes (M-he or M-hes; He Or Hes With Docmentioning

confidence: 99%

How I treat hypereosinophilic syndromes

Klion

2015

Blood

193

126

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Hypereosinophilic syndromes (HESs) are a group of rare disorders characterized by peripheral blood eosinophilia of 1.5 × 109/L or higher and evidence of end organ manifestations attributable to the eosinophilia and not otherwise explained in the clinical setting. HESs are pleomorphic in clinical presentation and can be idiopathic or associated with a variety of underlying conditions, including allergic, rheumatologic, infectious, and neoplastic disorders. Moreover, the etiology of the eosinophilia in HESs can be primary (myeloid), secondary (lymphocyte-driven), or unknown. Although corticosteroids remain the first-line therapy for most forms of HESs, the availability of an increasing number of novel therapeutic agents, including tyrosine kinase inhibitors and monoclonal antibodies, has necessarily altered the approach to treatment of HESs. This review presents an updated treatment-based approach to the classification of patients with presumed HES and discusses the roles of conventional and novel agents in the management of these patients.

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Section: Myeloproliferative He/hes (M-he or M-hes; He Or Hes With Docmentioning

confidence: 99%

How I treat hypereosinophilic syndromes

Klion

2015

Blood

193

126

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“…However, due to the fact that only up to 5 children per each dietary treatment group underwent a histological evaluation, no strict conclusions could be drawn from the above study [23]. An interesting finding in that study, however, was that although 86% of patients were found to be sensitized to several foods using skin prick tests or serum analyses, no correlation was found between response to dietary therapy and food sensitization [23]. …”

Section: Eosinophilic Gastritismentioning

confidence: 95%

“…Of these, the mucosal involvement is the most common, presenting clinically with epigastric pain, nausea, vomiting, and early satiety, while the laboratory findings include peripheral eosinophilia, hypoalbuminemia, and iron deficiency anemia [23]. Furthermore, case reports in infants have attributed pyloric stenosis to EG [24] and the same was true for isolated giant ulcers resistant to PPIs, mainly in adolescent girls [25].…”

Section: Eosinophilic Gastritismentioning

confidence: 99%

Section: Eosinophilic Gastritismentioning

confidence: 99%

“…Ko et al [23] reported, in a retrospective study, that 82% of the patients with EG achieved clinical and 78% histological remission following elimination diet (elemental diet, elimination diet excluding milk, egg, wheat, soy, peanut/tree nuts, fish/shellfish, and red meat from the diet and also empiric avoidance of 1–3 foods). However, due to the fact that only up to 5 children per each dietary treatment group underwent a histological evaluation, no strict conclusions could be drawn from the above study [23]. An interesting finding in that study, however, was that although 86% of patients were found to be sensitized to several foods using skin prick tests or serum analyses, no correlation was found between response to dietary therapy and food sensitization [23].…”

Section: Eosinophilic Gastritismentioning

confidence: 99%

See 2 more Smart Citations

Eosinophilic Gastrointestinal Diseases in Childhood

Koutri

Papadopoulou

2018

Ann Nutr Metab

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Eosinophilic gastrointestinal diseases (EGIDs) comprise a group of chronic, inflammatory diseases of the gastrointestinal (GI) tract, that are characterized, clinically, by symptoms related to the dysfunction of the involved segment(s) of the GI tract, and histologically, by dense eosinophilic inflammation, in the absence of an identifiable secondary cause. The group of EGIDs comprises eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), and eosinophilic colitis (EC). EoE is the most common and the best described EGID compared to EG, EGE, and EC. The clinical presentation of the EGIDs differs depending on the location and the extent of the eosinophilic infiltration in the GI tract, as well as its depth through the bowel wall. In the absence of biological markers, the diagnosis is based on the combination of clinical symptoms with the histological features of EGIDs, after the exclusion of secondary causes of eosinophilic inflammation of the GI tract. Treatment is individualized and includes elimination diets (mainly empiric or elemental) and/or drugs, according to the involved GI segment: proton pump inhibitors or local steroids in EoE; local or oral systemic steroids in EG/EGE limited to the duodenum; oral systemic steroids in EGE with lower small intestine and/or colon involvement. In patients with EoE, maintenance treatment with lower doses may be considered following histological remission with the means of drugs. In patients treated with elimination diets, disease food triggers identified during food reintroduction need to be further eliminated. Esophageal stenosis despite medical treatment requires endoscopic dilation, while the use of thiopurines or anti-TNF drugs may be considered in refractory or steroid-dependent EGID (other than EoE). The aim of this review is to provide the available evidence on each of the above disorders, to aid clinicians to interpret the clinical manifestations and the laboratory findings and choose the best available treatment option.

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Primary eosinophilic gastrointestinal disorders and allergy: Clinical and therapeutic implications

Rossi

Lenti

Merli

et al. 2022

Clinical & Translational All

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Primary eosinophilic gastrointestinal disorders (EGID) are increasingly prevalent, immune‐mediated, chronic conditions which primarily affect pediatric and young adult patients, leading to substantial disease burden, and poor quality of life. EGID may either involve single portions of the gastrointestinal tract (i.e., esophagus, stomach, small bowel, and colon) or a combination. Their strong association with allergic disorders has been recently recognized, and although their shared pathophysiological basis remains partly elusive, this feature greatly impacts the diagnostic and treatment work‐up. We herein critically discuss the current knowledge on the association of EGID and allergic disorders, including atopic dermatitis, allergic rhinitis, allergic asthma, and food or drug allergy. In particular, we reviewed the literature focusing on their epidemiology, pathophysiological basis and mechanisms, and diagnostic strategies. Finally, we discuss the currently ongoing clinical trials targeting EGID and allergic diseases, including, among others the monoclonal antibodies dupilumab, mepolizumab, benralizumab, and lirentelimab.

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Eosinophilic Gastritis in Children: Clinicopathological Correlation, Disease Course, and Response to Therapy

Cited by 162 publications

References 19 publications

How I treat hypereosinophilic syndromes

How I treat hypereosinophilic syndromes

Eosinophilic Gastrointestinal Diseases in Childhood

Primary eosinophilic gastrointestinal disorders and allergy: Clinical and therapeutic implications

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