Concurrent eosinophilic esophagitis in pediatric patients with inflammatory bowel disease

Talathi, Saurabh; Knight, Taylor; Dimmitt, Reed A.; Mestre, José L.; Jester, Traci

doi:10.1016/j.anai.2019.06.010

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…In particular, 26–50% of EoE patients have concomitant asthma, 30–90% have associated allergic rhinitis, 19–55% have atopic dermatitis and, 9.8–68% have IgE-mediated food allergy [ 52 , 76 – 80 ]. Moreover, other non-atopic diseases have been shown to be associated with EoE, such as inflammatory bowel disease [ 81 ] connective tissue disorders [ 82 ], autism [ 83 ], attention deficit hyperactivity disorder [ 83 ], celiac disease [ 83 , 84 ] and other monogenic disorders [ 83 , 85 ]. This group of patients may be overrepresented in 21–25% cases by those who do not demonstrate concomitant allergic disease [ 78 ], as they could be represented by a different EoE-phenotype [ 86 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Pediatric eosinophilic esophagitis: a review for the clinician

et al. 2021

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Eosinophilic esophagitis (EoE) is a chronic clinical-pathologic disease characterized by eosinophilic infiltration of the esophageal epithelium with esophageal dysfunction symptoms.EoE can occur at any age and has different clinical manifestations depending on the age onset.To date, esophago-gastroduodenal endoscopy (EGD) with biopsy is the gold-standard for EoE diagnosis.According to the recent consensus guidelines, proton pump inhibitors, corticosteroids and elimination diets could be a first-line therapy option. The aim of the treatment is clinical and histological remission for preventing long-lasting untreatable fibrosis.A multidisciplinary approach (allergist, gastroenterology, dietitian, and pathologist) is recommended for managing patients affected by EoE, given the complexity of its treatment.This review will provide a practical guide to assist pediatricians treating children with EoE.Moreover, it highlights the unmet needs in diagnosis and treatment that require urgent attention from the scientific community in the aim of improving the management of patients with EoE.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Pediatric eosinophilic esophagitis: a review for the clinician

et al. 2021

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“…26,27 However, a significant proportion of patients with EoE do not demonstrate signs of allergy, suggesting that this may be a different phenotype. 28 Indeed, other non-atopic diseases, such as inflammatory bowel disease, 29 connective tissue disorders, 30 autism, 31 attention deficit hyperactivity disorder, 31 and additional monogenic disorders, 31,32 have been shown to be associated with EoE. These factors may modulate the presentation of EoE, leading to additional aspects of inflammation or fibrosis that differ from the classical atopic pathway.…”

Section: Atopic Vs Non-atopic Phenotypementioning

confidence: 99%

Phenotypes and endotypes in eosinophilic esophagitis

Ruffner

Cianferoni

2020

Annals of Allergy, Asthma & Immunology

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Eosinophilic esophagitis (EoE) shares many features with other atopic diseases such as asthma, including heterogeneity in its presentation, natural history, and response to treatment. Clinical and molecular evidence suggests that different eosinophilic esophagitis patient phenotypes and endotypes exist. Phenotypic variations in EoE include the age of onset, degree of atopic comorbidity, response to different forms of therapy, and disease severity, among others. Biomarkers that may provide insight into the mechanisms of EoE for defining endotypes include the presence or absence of systemic Th2 inflammation, genetic risk factors, and histologic findings.

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“…However, a significant number of EoE patients do not present allergic diseases, suggesting a possible non-atopic phenotype (2). Interestingly, several reports have suggested that EoE may be more frequently associated with some non-allergic disorders, including connective tissue disorders (74), autoimmune diseases (coeliac disease) ( 8), and contradictorily inflammatory bowel diseases (IBD) (8,(75)(76)(77), that are increased in the last decades, especially in Western countries (8). The pathogenetic mechanisms explaining the association between these non-atopic diseases and EoE are poorly understood and investigated.…”

Section: Diseases Of Modern Life and Phenotypes Of Eoementioning

confidence: 99%

Early Life Risk Factors in Pediatric EoE: Could We Prevent This Modern Disease?

et al. 2020

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Eosinophilic esophagitis (EoE) is a chronic antigen-mediated inflammatory disease that affects the esophagus. In the last 20 years, a large number of epidemiological studies showed a significant increase in the incidence and prevalence of EoE, especially in developed countries. This phenomenon might correlate to the overall increase in pediatric allergic diseases or might be a result of improved medical awareness and knowledge through modern diagnostic instruments. Since 1993, when EoE was first recognized as a distinct clinical entity, several signs of progress in the pathophysiology of EoE were achieved. However, a few studies reported data on early risk factors for pediatric EoE and how these factors may interfere with genes. Currently, the most defined risk factors for EoE are male sex, Caucasian race, and atopic comorbidities. Other putative risk factors may include alterations in epithelial barrier function and fibrous remodeling, esophageal dysbiosis, variation in the nature and timing of oral antigen exposure, and early prescription of proton pump inhibitors and antibiotics. Notably, the timing and nature of food antigen exposure may be fundamental in inducing or reversing immune tolerance, but no studies are reported. This review summarized the current evidence on the risk factors that might contribute to the increasing development of EoE, focusing on the possible preventive role of early interventions.

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Concurrent eosinophilic esophagitis in pediatric patients with inflammatory bowel disease

Cited by 8 publications

References 10 publications

Pediatric eosinophilic esophagitis: a review for the clinician

Pediatric eosinophilic esophagitis: a review for the clinician

Phenotypes and endotypes in eosinophilic esophagitis

Early Life Risk Factors in Pediatric EoE: Could We Prevent This Modern Disease?

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