Eosinophilic oesophagitis: clinical manifestations and treatment options. The role of the allergologist

Ferré-Ybarz, L.; Falco, S.; Plaza-Martin, Ana María

doi:10.1016/s0301-0546(08)75869-5

Cited by 10 publications

(8 citation statements)

References 36 publications

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“…Since then, its recognition as a clinically relevant and potentially manageable disorder has increased, first in pediatric and, more recently, in adult gastroenterology. EoE in adults is defined clinically by symptoms of esophageal dysfunction including dysphagia, reflux and food impaction (2,3). Histologically, it is defined by an eosinophil-predominant inflammatory response (4).…”

Section: Definition and Epidemiologymentioning

confidence: 99%

Recent Advances in the Recognition and Management of Eosinophilic Esophagitis

Eustace¹,

Gui²,

Iacucci

2015

Canadian Journal of Gastroenterology and Hepatology

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The incidence and recognition of eosinophilic esophagitis is increasing. Pathophysiological understanding of eosinophilic esophagitis is improving and an immunological reaction to ingested food is likely to play a significant role. Patients present with dysphagia and food bolus obstruction. Both histological and endoscopic criteria have been developed and validated. Dietary therapy, topical steroid therapy, proton pump inhibitors and endoscopic dilation are the main approaches to therapy; however, novel targeted therapies are being developed. Among the food items commonly implicated are wheat, dairy, nuts, soy, shellfish and eggs. A multidisciplinary approach to management in dedicated clinics may yield the best results.

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Section: Definition and Epidemiologymentioning

confidence: 99%

Recent Advances in the Recognition and Management of Eosinophilic Esophagitis

Eustace¹,

Gui²,

Iacucci

2015

Canadian Journal of Gastroenterology and Hepatology

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“…Adults typically present with symptoms of dysphagia, food impactions, and heartburn. 3, 4 Although children can also present with swallowing difficulties, they most commonly have non-specific symptoms such as abdominal pain, vomiting, and failure to thrive. 5–7 EoE is a relatively new disease, so our understanding is limited; because patients often present with nonspecific symptoms, it can be a challenge to diagnose.…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Diagnostic Utility of Endoscopic Features of Eosinophilic Esophagitis: A Meta-analysis

Kim¹,

Vance²,

Shaheen³

et al. 2012

Clinical Gastroenterology and Hepatology

292

269

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Background & Aims Endoscopic findings such as esophageal rings, strictures, narrow-caliber esophagus, linear furrows, white plaques, and pallor or decreased vasculature might indicate the presence of eosinophilic esophagitis (EoE). We aimed to determine the prevalence and diagnostic utility of endoscopic features of EoE. Methods We conducted a systematic review and meta-analysis. PubMed, EMBASE, and GI meeting abstracts were searched to identify studies that included ≥ 10 patients with EoE and reported endoscopic findings. Pooled prevalence, sensitivity, specificity, and predictive values were calculated using random- and mixed-effects models. Results The search yielded 100 articles and abstracts on 4678 patients with EoE and 2742 without (controls). In subjects with EoE, the overall pooled prevalence of esophageal rings was 44%, strictures 21%, narrow-caliber esophagus 9%, linear furrows 48%, white plaques 27%, and pallor/decreased vasculature 41%. Substantial heterogeneity existed among studies. Results from endoscopy examinations were normal in 17% of patients, but this number decreased to 7% when the analysis was limited to prospective studies (P<.05). Overall levels of sensitivity were modest, ranging from 15% to 48%, whereas levels of specificity were greater, ranging from 90% to 95%. Positive predictive values ranged from 51% to 73% and negative predictive values ranged from 74% to 84%. Conclusions There is heterogeneity among studies in the reported prevalence of endoscopic findings in patients with EoE, but in prospective studies, at least 1 abnormality was detected by endoscopy in 93% of patients. The operating characteristics of endoscopic findings alone are inadequate for diagnosis of EoE. Esophageal biopsies should be obtained from all patients with clinical features of EoE, regardless of the endoscopic appearance of the esophagus.

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“…La EEo es una patología poco frecuente caracterizada por la inflamación con infiltrado eosinofílico del esófago sin reflujo gastroesofágico 2 . Se ha descrito en niños 3,4 y adultos, aunque aparentemente es más prevalente en los primeros; en éstos, a diferencia de los adultos, se observan eosinofilia periférica y antecedentes de alergia.…”

Section: Discussionunclassified

Esofagitis eosinofílica: a propósito de un caso

Hurtado

Bascones

Martínez

2009

Rev Pediatr Aten Primaria

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Resumen La esofagitis eosinofílica es una enfermedad inusual y emergente en los últimos años que se caracteriza por un infiltrado de más de 20 eosinófilos por campo de gran aumento en la biopsia del tejido esofágico. Se describe en todas las edades aunque aparentemente es más frecuente en niños. La etiología no está clara pero se sugiere que la atopia o las alergias juegan un rol importante en el desarrollo de la enfermedad. La presentación clínica es variada: la disfagia y la impactación alimentaria son las más frecuentes. No existe un tratamiento específico. Los corticoides tópicos deglutidos son los fármacos de elección, pero en niños con alergia alimentaria el tratamiento se basa en dietas de exclusión. Presentamos el caso clínico de un niño de 12 años con antecedente de dermatitis atópica y alergia que es hospitalizado por presentar un cuadro de melena con urticaria aguda. A su vez, se hace una breve revisión del diagnóstico y el tratamiento de esta patología.

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Eosinophilic oesophagitis: clinical manifestations and treatment options. The role of the allergologist

Cited by 10 publications

References 36 publications

Recent Advances in the Recognition and Management of Eosinophilic Esophagitis

Recent Advances in the Recognition and Management of Eosinophilic Esophagitis

The Prevalence and Diagnostic Utility of Endoscopic Features of Eosinophilic Esophagitis: A Meta-analysis

Esofagitis eosinofílica: a propósito de un caso

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