Diagnosis and treatment of eosinophilic esophagitis
Eosinophilic esophagitis (EoE) is an eosinophil-rich, TH2 antigen–mediated disease of increasing pediatric and adult worldwide prevalence. Diagnosis requires greater than or equal to 15 eosinophils per high-power field on light microscopy. Symptoms reflect esophageal dysfunction, and typical endosco...
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| Veröffentlicht in: | Journal of allergy and clinical immunology 2020-01, Vol.145 (1), p.1-7 |
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| creator | Gonsalves, Nirmala P. Aceves, Seema S. |
| description | Eosinophilic esophagitis (EoE) is an eosinophil-rich, TH2 antigen–mediated disease of increasing pediatric and adult worldwide prevalence. Diagnosis requires greater than or equal to 15 eosinophils per high-power field on light microscopy. Symptoms reflect esophageal dysfunction, and typical endoscopic features include linear furrows, white plaques, and concentric rings. Progressive disease leads to pathologic tissue remodeling, with ensuing esophageal rigidity and loss of luminal diameter caused by strictures. Therapies include proton pump inhibitors, elimination diets, and topical corticosteroids. Effective treatment can reverse tissue fibrosis in some patients, as well as decrease the rate of food impactions. Esophageal dilation might be required to increase luminal patency. The chronic nature of EoE necessitates long-term therapy to avoid disease recurrence and complications. This review serves the function of providing the current state-of-the-art diagnostic criteria and disease management for adult and pediatric EoE. |
| doi_str_mv | 10.1016/j.jaci.2019.11.011 |
| format | Article |
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Diagnosis requires greater than or equal to 15 eosinophils per high-power field on light microscopy. Symptoms reflect esophageal dysfunction, and typical endoscopic features include linear furrows, white plaques, and concentric rings. Progressive disease leads to pathologic tissue remodeling, with ensuing esophageal rigidity and loss of luminal diameter caused by strictures. Therapies include proton pump inhibitors, elimination diets, and topical corticosteroids. Effective treatment can reverse tissue fibrosis in some patients, as well as decrease the rate of food impactions. Esophageal dilation might be required to increase luminal patency. The chronic nature of EoE necessitates long-term therapy to avoid disease recurrence and complications. 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Published by Elsevier Inc. 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Diagnosis requires greater than or equal to 15 eosinophils per high-power field on light microscopy. Symptoms reflect esophageal dysfunction, and typical endoscopic features include linear furrows, white plaques, and concentric rings. Progressive disease leads to pathologic tissue remodeling, with ensuing esophageal rigidity and loss of luminal diameter caused by strictures. Therapies include proton pump inhibitors, elimination diets, and topical corticosteroids. Effective treatment can reverse tissue fibrosis in some patients, as well as decrease the rate of food impactions. Esophageal dilation might be required to increase luminal patency. The chronic nature of EoE necessitates long-term therapy to avoid disease recurrence and complications. This review serves the function of providing the current state-of-the-art diagnostic criteria and disease management for adult and pediatric EoE.</description><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>corticosteroid</subject><subject>diet</subject><subject>Diet Therapy</subject><subject>dysphagia</subject><subject>Eosinophil</subject><subject>Eosinophilic Esophagitis - diagnosis</subject><subject>Eosinophilic Esophagitis - immunology</subject><subject>Eosinophilic Esophagitis - pathology</subject><subject>Eosinophilic Esophagitis - therapy</subject><subject>Eosinophils - immunology</subject><subject>Eosinophils - pathology</subject><subject>Esophagus - immunology</subject><subject>Esophagus - pathology</subject><subject>fibrosis</subject><subject>Humans</subject><subject>Proton Pump Inhibitors - therapeutic use</subject><subject>remodeling</subject><subject>stricture</subject><issn>0091-6749</issn><issn>1097-6825</issn><issn>1097-6825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMoun78AQ_So5fWSZOmDYggfoPgRc8hTSe7WbrNmnQF_71ZdhW9eEoyeead4SHklEJBgYqLeTHXxhUlUFlQWgClO2RCQda5aMpql0wAJM1FzeUBOYxxDunNGrlPDhiViWvYhLBbp6eDjy5meuiyMaAeFziMmbcZpvLglzPXO5NhTDc9daOLx2TP6j7iyfY8Im_3d683j_nzy8PTzfVzbnhVjbm1LdNty2xn2lYjB9tazqFkYMEaAzXWjbWdhk5wKSTtTCWxFgy5tbwqGTsiV5vc5apdYGfSWkH3ahncQodP5bVTf38GN1NT_6GEbETdlCngfBsQ_PsK46gWLhrsez2gX0WVZnAhJQNIaLlBTfAxBrQ_YyiotW01V2vbam1bUaqS7dR09nvBn5ZvvQm43ACYNH04DCoah4PBzgU0o-q8-y__CypIkwU</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Gonsalves, Nirmala P.</creator><creator>Aceves, Seema S.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202001</creationdate><title>Diagnosis and treatment of eosinophilic esophagitis</title><author>Gonsalves, Nirmala P. ; Aceves, Seema S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-ffb3abb3fdcbbae40fbf440230f0fcc07e78ffda0d649691dc59e763e4ff45233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>corticosteroid</topic><topic>diet</topic><topic>Diet Therapy</topic><topic>dysphagia</topic><topic>Eosinophil</topic><topic>Eosinophilic Esophagitis - diagnosis</topic><topic>Eosinophilic Esophagitis - immunology</topic><topic>Eosinophilic Esophagitis - pathology</topic><topic>Eosinophilic Esophagitis - therapy</topic><topic>Eosinophils - immunology</topic><topic>Eosinophils - pathology</topic><topic>Esophagus - immunology</topic><topic>Esophagus - pathology</topic><topic>fibrosis</topic><topic>Humans</topic><topic>Proton Pump Inhibitors - therapeutic use</topic><topic>remodeling</topic><topic>stricture</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gonsalves, Nirmala P.</creatorcontrib><creatorcontrib>Aceves, Seema S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of allergy and clinical immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gonsalves, Nirmala P.</au><au>Aceves, Seema S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis and treatment of eosinophilic esophagitis</atitle><jtitle>Journal of allergy and clinical immunology</jtitle><addtitle>J Allergy Clin Immunol</addtitle><date>2020-01</date><risdate>2020</risdate><volume>145</volume><issue>1</issue><spage>1</spage><epage>7</epage><pages>1-7</pages><issn>0091-6749</issn><issn>1097-6825</issn><eissn>1097-6825</eissn><abstract>Eosinophilic esophagitis (EoE) is an eosinophil-rich, TH2 antigen–mediated disease of increasing pediatric and adult worldwide prevalence. Diagnosis requires greater than or equal to 15 eosinophils per high-power field on light microscopy. Symptoms reflect esophageal dysfunction, and typical endoscopic features include linear furrows, white plaques, and concentric rings. Progressive disease leads to pathologic tissue remodeling, with ensuing esophageal rigidity and loss of luminal diameter caused by strictures. Therapies include proton pump inhibitors, elimination diets, and topical corticosteroids. Effective treatment can reverse tissue fibrosis in some patients, as well as decrease the rate of food impactions. Esophageal dilation might be required to increase luminal patency. The chronic nature of EoE necessitates long-term therapy to avoid disease recurrence and complications. 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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adrenal Cortex Hormones - therapeutic use corticosteroid diet Diet Therapy dysphagia Eosinophil Eosinophilic Esophagitis - diagnosis Eosinophilic Esophagitis - immunology Eosinophilic Esophagitis - pathology Eosinophilic Esophagitis - therapy Eosinophils - immunology Eosinophils - pathology Esophagus - immunology Esophagus - pathology fibrosis Humans Proton Pump Inhibitors - therapeutic use remodeling stricture |
| title | Diagnosis and treatment of eosinophilic esophagitis |
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