Upper Gastrointestinal Bleeding as the First Presentation of Eosinophilic Gastrointestinal Disease

Özdoğan, Elif Bahat; Çağlayan, Latife Doğanay; Mizikoglu, Ozlem; Arıkan, Çiğdem

doi:10.1097/pg9.0000000000000017

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…Additionally, symptomology of EG at presentation was also observed to be different when compared to EoE. We found that GI bleeding featured strongly in our cohort of patients regardless of age of onset, similar to a recently published review by Ozdogan et al, 12 which described GI bleeding as a frequent initial presenting symptom of EG.…”

Section: Discussionsupporting

confidence: 89%

Clinical, histopathological features and efficacy of elimination diet and proton‐pump inhibitor therapy in achieving histological remission in Asian children with eosinophilic gastritis

Loh

Ong

et al. 2022

J Paediatrics Child Health

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Aim: Paediatric eosinophilic gastritis (EG) is a rare disorder and existing literature on diagnostic criteria and management remains lacking. We aim to describe the clinical spectrum and assess the efficacy of dietary elimination and proton-pump inhibitor (PPI) therapy, with particular emphasis on histologic remission in children with primary EG. Methods: We performed a retrospective study of patients aged 0-18 years diagnosed with EG at a single centre in Singapore from 2013 to 2021. EG was diagnosed based on histological criteria of infiltration of >30 eosinophils per high-power film (HPF) in >5 separate HPFs from gastric biopsies, in the absence of other causes. First-line treatment consisted of PPI therapy and empiric 1-6 food elimination diet (FED). Outcomes measured were clinical, endoscopic and histological remission (defined as eosinophil count <20/HPF in gastric biopsies).Results: Twenty-one (66.7% females) patients were included with median age at diagnosis of 15 months (range:3-192). Majority presented with vomiting (76.2%) and gastrointestinal bleeding (71.4%). Twenty patients were initiated on FED+PPI and 16 had post-treatment biopsies. Clinical, endoscopic and histologic remissions were achieved in 94.7%, 81.3% and 68.8% respectively following FED+PPI. Histologic remission was significantly associated with younger age (9 vs. 132 months; P = 0.026). Four patients who did not respond to FED+PPI were started on oral viscous budesonide, of whom one achieved histological remission and two had clinical improvement. Conclusions: FED+PPI is effective as first-line treatment in achieving histological remission in paediatric EG particularly in younger patients. Topical corticosteroids can be considered for those who have failed FED+PPI therapy.

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Section: Discussionsupporting

confidence: 89%

Clinical, histopathological features and efficacy of elimination diet and proton‐pump inhibitor therapy in achieving histological remission in Asian children with eosinophilic gastritis

Loh

Ong

et al. 2022

J Paediatrics Child Health

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“…In our study, hematemesis occurred in 1 patient during the build‐up phase of OIT, which is an uncommon symptom of EoE, especially in children. However, several case series have been published that hematemesis occurred in 1.4% of children with EoE (35).…”

Section: Discussionmentioning

confidence: 99%

Oral Immunotherapy and Risk of Eosinophilic Esophagitis in Children

Morales‐Cabeza

Infante

Cabrera‐Freitag

et al. 2022

J. pediatr. gastroenterol. nutr.

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Objectives: Oral immunotherapy (OIT) is an effective treatment for children with persistent food allergy, and has concerns about its safety, including eosinophilic esophagitis (EoE). The aim of this study was to evaluate the prevalence of EoE in a large cohort of children who underwent OIT in our center, and to determine if there were any clinical, endoscopic, or histologic differences depending on the food employed for the OIT. Methods: A retrospective study was performed over a 15-year period (2005–2020). Children who underwent cow’s milk (CM), egg, and/or peanut OIT and developed EoE were included. Results: Six hundred and seven OIT were carried out (277 CM-OIT, 322 egg-OIT, and 8 peanut-OIT). Seventeen patients (2.8%) had a confirmed histologic diagnosis of EoE with a higher prevalence for patients who underwent CM-OIT (3.9%) than egg-OIT (2.2%). Symptoms suggestive of EoE and a confirmed diagnosis occurred at median times of 25 and 36 months, respectively, after the build-up phase of the OIT was completed. Choking, abdominal pain, and dysphagia were the most frequent symptoms and lamina propria fibrosis was observed in 41.2% of patients. No significant differences in clinical symptoms, endoscopic, or histologic findings between patients under CM or egg-OIT were found. One-third of patients reported mild symptoms suggestive of EoE before the OIT. Conclusions: EoE appears to be a rare but important adverse event that can occur even years after OIT. Validated questionnaires to screen EoE before the OIT and in the follow-up of these patients may be the main tool for an early diagnosis.

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Endoscopy in Pediatric Eosinophilic Esophagitis

Sabe

Hiremath

2023

Gastrointestinal Endoscopy Clinics of North America

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Upper Gastrointestinal Bleeding as the First Presentation of Eosinophilic Gastrointestinal Disease

Cited by 4 publications

References 30 publications

Clinical, histopathological features and efficacy of elimination diet and proton‐pump inhibitor therapy in achieving histological remission in Asian children with eosinophilic gastritis

Clinical, histopathological features and efficacy of elimination diet and proton‐pump inhibitor therapy in achieving histological remission in Asian children with eosinophilic gastritis

Oral Immunotherapy and Risk of Eosinophilic Esophagitis in Children

Endoscopy in Pediatric Eosinophilic Esophagitis

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