Eosinophilic Esophagitis

Abstract

Once considered a rare condition, eosinophilic esophagitis is now one of the most common conditions diagnosed during the assessment of feeding problems in children and during the evaluation of dysphagia and food impaction in adults.1 The entity exists worldwide but has been most extensively studied in Western countries, where its prevalence has been estimated to be 0.4% among all children and adults.2 Whether eosinophilic esophagitis is truly a new disease or simply a recently recognized one is uncertain.3 In this review, we consider the diagnostic criteria, pathophysiological and clinical features, and treatment of this increasingly prevalent disease.

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

“…EoE may affect all age groups but it is more common among men (3:1) and Caucasians, and it occurs in 8-10% of children with suspected anti-reflux-refractory GERD. 3,9 EoE is believed to be a Th2 cell-mediated entity triggered by food and/or environmental antigens. There is an increase in interleukin (IL)-5 and IL-13, which are responsible for eosinophil differentiation and maturation, and for stimulating the esophageal epithelium to produce eotaxin-3, that recruits eosinophils.…”

“…Such altered epithelial permeability can lead to a permissive environment that enhances antigen presentation, which in turn leads to eosinophil recruitment. 9 The clinical manifestations vary depending on age: infants may have difficulty eating (food refusal, regurgitation, and vomiting) and growth failure. In preschoolers and school children, nausea, vomiting, heartburn, and chest pain are predominant.…”

Esofagitis eosinofílica y atresia esofágica: ¿casualidad o causalidad?

“…Esta permeabilidad alterada puede conducir a un entorno permisivo que mejora la presentación de antígenos y conduce al reclutamiento de eosinófilos. 9 Las manifestaciones clínicas varían de acuerdo con la edad: los lactantes pueden tener dificultades en la alimentación (rechazo del alimento, regurgitación y vómitos) y falla del crecimiento. En preescolares y escolares, predominan náuseas, vómitos, pirosis y dolor torácico.…”

“…Puede afectar a todos los grupos etarios; es más frecuente en hombres (3:1) y en la raza blanca, y se presenta en el 8-10% de los niños con sospecha de ERGE refractaria al tratamiento antirreflujo. 3,9 Se acepta que es una entidad mediada por activación celular tipo Th-2, inducida por antígenos alimentarios y/o ambientales. Existe incremento de interleuquina (IL)-5 e IL-13, encargadas de la diferenciación y maduración de eosinófilos, y de estimular al epitelio esofágico para producir eotaxina-3, que recluta eosinófilos.…”

Creating a multi-center rare disease consortium – the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR)

“…This committee facilitates the timely reporting of study results through support to the primary authors. A wide variety of publications has emerged from CEGIR including review articles, [12, 14, 18, 29] editorials, and original research articles. Research published thus far has focused on a wide range of topics including disease mechanisms, [4, 5, 13, 24, 31] pathology and histology, [32, 33, 35] diagnosis, [7] and various treatment options for EGIDs including steroids, [17, 34] diet changes, [3, 43] and proton pump inhibitors [9, 22].…”