Long-term Follow-up of Symptoms and Peripheral Eosinophil Counts in Seven Children with Eosinophilic Esophagitis

Esposito, Stefania; Marinello, Daniela; Paracchini, R.; Guidali, Paola; Oderda, Giuseppina

doi:10.1097/00005176-200404000-00016

Cited by 32 publications

(25 citation statements)

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“…Population-based findings in children suggest an incidence of 1 in 10 000 and a prevalence of 4 in 10 000 25. An Italian study estimated a rather high prevalence of 3.5% in children 26. There appears to be a familial aspect to EO, implicating genetic factors 27.…”

Section: Eosinophils In Gastrointestinal Diseasementioning

confidence: 96%

Primary eosinophilic disorders of the gastrointestinal tract

Yan

Shaffer

2008

Gut

177

163

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Eosinophils are important effector cells of the innate immune system. Eosinophilic infiltrative disorders of the gastrointestinal tract, though recognised for decades, have recently witnessed a resurgence of interest, particularly for oesophageal disease. A more comprehensive basis for eosinophilic infiltration and activation has identified interleukin 5 (IL5) as a key cytokine for the differentiation and proliferation of eosinophils, while eotaxins promote the recruitment of mature eosinophils to the gut. When activated, eosinophils release multiple cytotoxic agents and immunomodulatory cytokines, resulting in local inflammation and tissue damage. Although eosinophils normally convey a defence against unwanted interlopers such as parasites, in the absence of such inciting agents, their accumulation and activation can elicit the primary infiltrative disorders of the gut: eosinophilic oesophagitis, gastroenteritis and colitis. Diagnosis of these disorders is dependent on the clinical presentation, endoscopic findings (particularly for eosinophilic oesophagitis), and most importantly, histological confirmation. Dietary modifications and topical corticosteroids are first-line treatments for eosinophilic oesophagitis. Systemic corticosteroids are the mainstay of treatment for eosinophilic gastroenteritis; surgery may be required depending on the layer of mucosa involved. Eosinophilic colitis most often occurs in infants; removal of the causative allergen usually results in a complete response. Steroids may be required for older children/adolescents or adults. This review summarises current knowledge on the trafficking of eosinophils to the gastrointestinal tract and the clinical management of the primary disorders of eosinophilic oesophagitis, eosinophilic gastroenteritis and eosinophilic colitis.

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Section: Eosinophils In Gastrointestinal Diseasementioning

confidence: 96%

Primary eosinophilic disorders of the gastrointestinal tract

Yan

Shaffer

2008

Gut

177

163

View full text Add to dashboard Cite

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“…2 3 Eosinophilic oesophagitis is a chronic condition localised to the oesophagus, often with intermittent symptoms. [3][4][5] Symptoms are similar to those of GORD, making clinical differentiation difficult. 6 7 Dysphagia and food bolus obstruction (with or without stricture formation) have been documented, more commonly in older children and adults, necessitating oesophogastroduodenoscopy, dilatation or disimpaction.…”

mentioning

confidence: 99%

Rapidly increasing prevalence of eosinophilic oesophagitis in Western Australia

Cherian¹,

Smith

Forbes

2006

Archives of Disease in Childhood

218

141

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“…Normal pH monitoring results nearly eliminate gastroesophageal reflux disease as the aetiology of intractable oesophagitis. 21 The exact aetiology of eosinophilic oesophagitis is not known. This finding may explain why some patients may have a partial response to acid blockade.…”

Section: Discussionmentioning

confidence: 99%

“…To date, no studies have clearly defined the upper limit of the normal range for eosinophils visualised within the epithelium of adults and children with gastroesophageal reflux disease; however, this number is thought to be less than five per high power field, with the eosinophilia being limited to the distal oesophagus. 21 . The epithelium contained a dense eosinophilic infiltrate, greater than 50 per high power field, a density too high to be attributable to gastroesophageal reflux alone.…”

Section: Discussionmentioning

confidence: 99%