Eosinophilic Esophagitis: A Prevalent Disease in the United States That Affects All Age Groups

Kapel, Robert C.; Miller, J.; Torres, Carlos; Aksoy, Saime; Lash, Richard H.; Katzka, David A.

doi:10.1053/j.gastro.2008.02.016

Cited by 299 publications

(269 citation statements)

References 19 publications

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“…In the present study, we collected 2-3 fragments from each third, and 9/34 biopsies did not meet the diagnostic criteria. The clinical features described by our study are similar to those reported elsewhere, with predominance of males (78.6%), as well as frequent abdominal pain, vomiting, failure to thrive and regurgitation, symptoms that resemble gastroesophageal reflux disease (GERD) (11,27) . Furthermore, EoE is a immunologically-mediated disease, and most patients present evidence of food allergy and/or atopy (7,24) .…”

Section: Discussionsupporting

confidence: 87%

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Histological Features of Eosinophilic Esophagitis in Children and Adolescents

Carrasco

Machado

Patrı́cio

et al. 2017

Arq. Gastroenterol.

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-Background -Eosinophilic esophagitis is an emerging disease featured by eosinophilic esophageal infiltrate not responsive to proton pump inhibitors. Objective -To characterize histological features of children and adolescents with eosinophilic esophagitis. Methods -Cross-sectional study in a tertiary hospital. Biopsies from each esophageal third from 14 patients (median age 7 years) with eosinophilic esophagitis were evaluated. Histological features evaluated included morphometry of esophageal epithelium, esophageal density (per high power field), extracellular eosinophilic granules, eosinophilic microabscesses, surface disposition of eosinophils, epithelial desquamation, peripapillary eosinophilia, basal layer hyperplasia and papillary elongation. Results -Several patients presented a normal esophageal macroscopy in the upper digestive endoscopy (6, 42.8%), and the most common abnormality were vertical lines (7, 50%) and whitish spots over esophageal mucosa (7, 50%). Basal layer hyperplasia was observed in 88.8%, 100% e 80% of biopsies from proximal, middle and lower esophagus, respectively (P=0.22). Esophageal density ranges from 0 to more than 50 per hpf. Extracellular eosinophilic granules (70%-100%), surface disposition of eosinophils (60%-93%), epithelial desquamation (60%-100%), peripapillary eosinophilia (70%-80%) were common, but evenly distributed among each esophageal third. Just one patient did not present eosinophils in the lower third, four in the middle third and four in the upper esophageal third. Conclusion -In the absence of hypereosinophilia, other histological features are present in eosinophilic esophagitis and may contribute to diagnosis. Eosinophilic infiltrate is focal, therefore multiple biopsies are needed for diagnosis.

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Section: Discussionsupporting

confidence: 87%

“…Overall prevalence has been estimated 1:10000, with 1:2500 incidence in developed countries (11,20) . Although the incidence has been increasing in the last years, the disease is still regarded uncommon (9).…”

Section: Introductionmentioning

confidence: 99%

Histological Features of Eosinophilic Esophagitis in Children and Adolescents

Carrasco

Machado

Patrı́cio

et al. 2017

Arq. Gastroenterol.

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“…EoE has been described in patients of various ages, from 1 to 98 years-old [28]. In both children and adults it has been described as a predominantly male disorder, being at least three-times more frequent in males than in females [28].…”

Section: Clinical Aspects Of Eoementioning

confidence: 99%

“…In both children and adults it has been described as a predominantly male disorder, being at least three-times more frequent in males than in females [28]. It is important to note that symptoms leading to endoscopy vary considerably between pediatric and adult patients, more than any other aspect of the disease.…”

Section: Clinical Aspects Of Eoementioning

confidence: 99%

“…Another early finding was that the treatment of GERD with antisecretive drugs or fundoplication proved ineffective in pediatric patients that presented with eosinophilic infiltration of the esophagus [29]. A nation-wide database in the USA identified heartburn and abdominal pain/dyspepsia as the main reported symptoms in 38.1 and 31% of children suffering from EoE, respectively [28]. Other symptoms commonly reported for children includes nausea, gagging, regurgitation, chest pain, sialorrhea, decreased appetite or food aversion, delayed growth, sleep difficulties and respiratory complaints (cough, stridor, sinusitis, obstruction and pneumonia) [3,30].…”

Section: Clinical Aspects Of Eoementioning

confidence: 99%

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