An allergist's perspective to the evaluation of Eosinophilic Esophagitis

Spergel, Jonathan M.

doi:10.1016/j.bpg.2015.06.011

Cited by 31 publications

(39 citation statements)

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“…EoE patients have a higher rate of atopic disease (asthma, allergic rhinitis, atopic dermatitis and food allergy) than the general population [15,29]. The patients in our series had a higher proportion of asthma than in other series of EoE patients and the general population.…”

Section: Discussionmentioning

confidence: 41%

Eosinophilic Esophagitis: Demographic, Clinical, Endoscopic, Histologic, and Atopic Characteristics of Children and Teenagers in a Region in Central Spain

Torrijos

Miranda

Palencia

et al. 2017

J Investig Allergol Clin Immunol

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Background and objective: Eosinophilic esophagitis (EoE) is an increasingly prevalent chronic inflammatory disease of the esophagus with an immunoallergic etiology. Few studies have been published on EoE in children and adolescents. The objective of this study was to analyze the demographic, clinical, serologic, endoscopic-histologic, and atopic characteristics of pediatric patients with EoE and to identify atopic and digestive comorbidities. Methods: We conducted a prospective observational study in children and adolescents (<16 years) assessed in a specialized multidisciplinary EoE unit in a tertiary referral hospital in a central region of Spain between 2011 and 2015. Results: Thirty-five patients were included in the study. Twenty-eight (80%) were male. The mean age was 9.6 years, 83% were atopic, and 28% reported a family history of atopy. The most common symptom was dysphagia (51%). Eosinophilia was detected in the blood of 60% of patients. Eosinophil cationic protein and total IgE were elevated in 88% and 77% of patients, respectively. The most frequent endoscopic finding was linear grooves (57%). Skin tests with aeroallergens were positive in 82% of patients (pollen 62% and food 60%). The main atopic comorbidities were asthma (48%) and rhinoconjunctivitis (37%). Digestive diseases were more often associated with gastritis and Helicobacter pylori infection (17%). Conclusions: Our results are similar to those previously reported. EoE is more common in boys and in individuals with a history of atopy and sensitization to airborne allergens and food. These results support the consideration of EoE as an atopic disease and underline the important role of allergists in early diagnosis and treatment.

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Section: Discussionmentioning

confidence: 41%

Eosinophilic Esophagitis: Demographic, Clinical, Endoscopic, Histologic, and Atopic Characteristics of Children and Teenagers in a Region in Central Spain

Torrijos

Miranda

Palencia

et al. 2017

J Investig Allergol Clin Immunol

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“…ATPs have been primarily developed to test children with atopic dermatitis and food‐induced exacerbations, but remain unstandardized to date. In EoE, ATPs have low sensitivity, particularly in adults . One explanation for the poor performance of these tests in EoE may be that allergen penetration into the skin is dependent on the epithelial barrier function.…”

Section: Allergy Testing In Eosinophilic Esophagitismentioning

confidence: 99%

Eosinophilic esophagitis: latest insights from diagnosis to therapy

Schoepfer

Blanchard

Dawson

et al. 2018

Annals of the New York Academy of Sciences

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Eosinophilic esophagitis (EoE) represents a chronic, local immune-mediated esophageal disease, characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. Other systemic and local causes of esophageal eosinophilia should be excluded. Clinical manifestations or pathologic data should not be interpreted in isolation. EoE was first described as a distinct disease entity in 1993. Most patients are diagnosed with underlying food allergies. The first diagnostic and therapeutic guidelines were published in 2007 with a first update in 2011. In 2017, new international guidelines were published based on the GRADE methodology. These guidelines provide, among many other topics, insights on the role of proton pump inhibitor-responsive esophageal eosinophilia. Over the last two decades, considerable progress was made by stakeholders regarding the understanding of EoE's pathogenesis, genetic background, natural history, allergy workup, standardization of assessment of disease activity, evaluation of minimally invasive diagnostic tools, and new therapeutic approaches. This brief review provides further insights into latest diagnostic and therapeutic advances.

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“…Levels of 10% to 20% have been reported in previous studies. 21 Aeroallergens have been shown to be associated with seasonal variation in clinical admissions in previous studies. 21 As with other allergic diseases, the incidence of EE seems to have increased during recent decades.…”

Section: T H I S S T U D Y D E S C R I B E S ( I ) T H E C L I N I C mentioning

confidence: 99%

“…21 Aeroallergens have been shown to be associated with seasonal variation in clinical admissions in previous studies. 21 As with other allergic diseases, the incidence of EE seems to have increased during recent decades. 4,5 It is difficult to estimate the true incidence of EE, because esophageal biopsy is the gold standard for diagnosis.…”

Section: T H I S S T U D Y D E S C R I B E S ( I ) T H E C L I N I C mentioning

confidence: 99%