Eosinophilic esophagitis – current overview of diagnostic and treatment modalities
Authors:
Kajzrlíková Mikoviny I. 1; Vitek P. 1,2
Authors place of work:
Interní oddělení, Beskydské Gastrocentrum, Nemocnice ve Frýdku-Místku, p. o.
1; Lékařská fakulta OU
2
Published in the journal:
Gastroent Hepatol 2020; 74(3): 228-232
Category:
Digestive Endoscopy: Review Article
doi:
https://doi.org/10.14735/amgh2020228
Summary
Eosinophilic esophagitis is immune-mediated inflammatory condition of the esophagus. It is a chronic disease with progressive esophageal remodeling. Eosinophilic esophagitis is characterized by symptoms of esophageal dysfunction and eosinophilic infiltration of the esophageal mucosa in the absence of secondary causes of eosinophilia. The management of eosinophilic esophagitis includes proton pump inhibitors, topical glucocorticoids and dietary interventions. Maintenance therapy should be considered for all patients. Endoscopic interventions include pneumatic dilation to treat strictures in symptomatic patients and extraction of impacted food bolus.
Keywords:
Diet – proton pump inhibitors – eosinophilic esophagitis – progression – corticoid – dilation
Zdroje
1. Lucendo AJ, Molina-Infante J, Arias Á et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J 2017; 5 (3): 335–358. doi: 10.1177/2050640616689525.
2. Attwood SE, Smyrk TC, Demeester TR et al. Esophageal eosinophilia with dysphagia. A distinct clinicopathologic syndrome. Dig Dis Sci 1993; 38 (1): 109–116. doi: 10.1007/BF01296781.
3. Straumann A, Spichtin HP, Bernoulli R et al. Idiopathic eosinophilic esophagitis: a frequently overlooked disease with typical clinical aspects and discrete endoscopic findings. Schweiz Med Wochenschr 1994; 124 (33): 1419–1429.
4. Dellon ES, Hirano I. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology 2018; 154 (2): 319–332. doi: 10.1053/j.gastro.2017.06.067.
5. Giriens B, Yan P, Safroneeva E et al. Escalating incidence of eosinophilic esophagitis in Canton of Vaud, Switzerland, 1993-2013: a population-based study. Allergy 2015; 70 (12): 1633–1639. doi: 10.1111/all.12733.
6. Whitney-Miller CL, Katzka D, Furth EE. Eosinophilic esophagitis: a retrospective review of esophageal biopsy specimens from 1992 to 2004 at an adult academic medical center. Am J Clin Pathol 2009; 131 (6): 788–792. doi: 10.1309/AJCPOMPXJFP7EB4P.
7. Molina-Infante J, Gonzalez-Cordero PL, Ferreira-Nossa HC et al. Rising incidence and prevalence of adult eosinophilic esophagitis in midwestern Spain (2007–2016). United European Gastroenterol J 2018; 6 (1): 29–37. doi: 10.1177/2050640617705913.
8. Jensen ET, Kuhl JT, Martin LJ et al. Early-life environmental exposures interact with genetic susceptibility variants in pediatric patients with eosinophilic esophagitis. J Allergy Clin Immunol 2018; 141 (2): 632–637. doi: 10.1016/j.jaci.2017.07.010.
9. Jensen ET, Dellon ES. Environmental factors and eosinophilic esophagitis. J Allergy Clin Immunol 2018; 142 (1): 32–40. doi: 10.1016/j.jaci.2018.04.015.
10. Okada H, Kuhn C, Feillet H et al. The hygiene hypothesis for autoimmune and allergic diseases: an update. Clin Exp Immunol 2010; 160 (1): 1–9. doi: 10.1111/j.1365-2249.2010.04139.x.
11. Elitsur Y, Alrazzak BA, Preston D et al. Does Helicobacter pylori protect against eosinophilic esophagitis in children? Helicobacter 2014; 19 (5): 367–371. doi: 10.1111/hel.12129.
12. Dellon ES, Peery AF, Shaheen NJ et al. Inverse association of esophageal eosinophilia with Helicobacter pylori based on analysis of a US pathology database. Gastroenterology 2011; 141 (5): 1586–1592. doi: 10.1053/j.gastro.2011.06.081.
13. Warners MJ, Oude Nijhuis RA, de Wijkerslooth LR et al. The natural course of eosinophilic esophagitis and long-term consequences of undiagnosed disease in a large cohort. Am J Gastroenterol 2018; 113 (6): 836–844. doi: 10.1038/s41395-018-0052-5.
14. Schoepfer AM, Safroneeva E, Bussmann C et al. Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner. Gastroenterology 2013; 145 (6): 1230–1236. doi: 10.1053/j.gastro.2013.08.015.
15. Dellon ES, Liacouras CA, Molina-Infante J et al.Updated international consensus diagnostic criteria for eosinophilic esophagitis: proceedings of the AGREE conference. Gastroenterology 2018; 155 (4): 1022–1033. doi: 10.1053/j.gastro.2018.07.009.
16. Dellon ES, Gibbs WB, Fritchie KJ et al. Clinical, endoscopic and histologic findings distinguish eosinophilic esophagitis from gastroesophageal reflux disease. Clin Gastroenterol Hepatol 2009; 7 (12): 1305–1313. doi: 10.1016/j.cgh.2009.08.030.
17. Bonis PA, Gupta SK. Clinical manifestations and diagnosis of eosinophilic esophagitis. 2020. [online]. Available from: www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-eosinophilic-esophagitis.
18. Hirano I, Moy N, Heckman MG et al. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system. Gut 2013; 62 (4): 489–495. doi: 10.1136/gutjnl-2011-301817.
19. Salek J, Clayton F, Vinson L et al. Endoscopic appearance and location dictate diagnostic yield of biopsies in eosinophilic oesophagitis. Aliment Pharmacol Ther 2015; 41 (12): 1288–1295. doi: 10.1111/apt.13201.
20. Nicodème F, Hirano I, Chen J et al. Esophageal distensibility as a measure of disease severity in patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol 2013; 11 (9): 1101–1107. doi: 10.1016/j.cgh.2013.03.020.
21. Shoda T, Wen T, Aceves SS et al. Eosinophilic oesophagitis endotype classification by molecular, clinical and histopathological analyses: a cross-sectional study. Lancet Gastroenterol Hepatol 2018; 3 (18): 477–488. doi: 10.1016/S2468-1253 (18) 30096-7.
22. Lucendo AJ, Arias Á, Molina-Infante J. Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14 (1): 13–22. doi: 10.1016/j.cgh.2015.07.041.
23. Molina-Infante J, Gonzalez-Cordero PL, Lucendo AJ. Proton pump inhibitor – responsive esophageal eosinophilia: still a valid diagnosis? Curr Opin Gastroenterol 2017; 33 (4): 285–292. doi: 10.1097/MOG.0000000000000371.
24. Molina-Infante J, Lucendo AJ. Proton pump inhibitor therapy for eosinophilic esophagitis: a paradigm shift. Am J Gastroenterol 2017; 112 (12): 1770–1773. doi: 10.1038/ajg.2017.404.
25. Cheng E, Zhang X, Huo X et al. Omeprazole blocks eotaxin-3 expression by oesophageal squamous cells from patients with eosinophilic oesophagitis and GORD. Gut 2013; 62 (6): 824–832. doi: 10.1136/gutjnl-2012-302250.
26. Menclová A, Hojný M, Dulavová M et al. Nové možnosti léčby eozinofilní ezofagitidy pomocí magistraliter připravovaného léčiva. Prakt lékáren 2016; 12 (1): 26–28. doi: 10.36290/lek.2016.006.
27. Bonis PA, Gupta SK. Treatment of eosinophilic esophagitis. 2019. [online]. Available from: www.uptodate.com/contents/treatment-of-eosinophilic-esophagitis.
28. Dellon ES, Woosley JT, Arrington A et al. Efficacy of budesonide vs fluticasone for initial treatment of eosinophilic esophagitis in a randomized controlled trial. Gastroenterology 2019; 157 (1): 65–73. doi: 10.1053/j.gastro.2019.03.014.
29. Lucendo AJ, Miehlke S, Schlag C et al. Efficacy of budesonide orodispersible tablets as induction therapy for eosinophilic esophagitis in a randomized placebo-controlled trial. Gastroenterology 2019; 157 (1): 74–86. doi: 10.1053/j.gastro.2019.03.025.
30. Arias A, Gonzalez-Cervera J, Tenias JM et al.Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis. Gastroenterology 2014; 146 (7): 1639–1648. doi: 10.1053/j.gastro.2014.02.006.
31. Molina-Infante J, Arias A, Alcedo J et al. Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: the 2–4–6 study. J Allergy Clin Immunol 2018; 141 (4): 1365–1372. doi: 10.1016/j.jaci.2017.08.038.
32. Zhan T, Ali A, Choi JG et al. Model to determine the optimal dietary elimination strategy for treatment of eosinophilic esophagitis. Clin Gastroenterol Hepatol 2018; 16 (11): 1730–1737. doi: 10.1016/j.cgh.2018.04.013.
33. Moawad FJ, Molina-Infante J, Lucendo AJ et al.Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis. Aliment Pharmacol Ther 2017; 46 (2): 96–105. doi: 10.1111/apt.14123.
Štítky
Paediatric gastroenterology Gastroenterology and hepatology SurgeryČlánok vyšiel v časopise
Gastroenterology and Hepatology
2020 Číslo 3
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
- Obstacle Called Vasospasm: Which Solution Is Most Effective in Microsurgery and How to Pharmacologically Assist It?
Najčítanejšie v tomto čísle
- Eosinophilic esophagitis – current overview of diagnostic and treatment modalities
- MUDr. Marek Beneš died on June 18, 2020 at the age of 44
- Motorized spiral enteroscopy – our first experience
- An unusual case of upper type dysphagia