Eosinophilic Esophagitis in Children: Symptoms, Histology and pH Probe Results

Abstract

Solid food dysphagia was the most common feature of eosinophilic esophagitis in our patients. Alkalinization of the esophagus was found in all nine pH probe recordings of eosinophilic esophagitis patients and may represent a previously unreported characteristic of the condition.

Basic Pathogenesis of Eosinophilic Esophagitis

“…Several external factors are known to increase basal cell expansion, such as gastric acid content in GERD disease. But the basal layer expansion observed in EE patients is more extensive in EE patients (56) suggesting that other etiologic factors influence EE disease pathogenesis. We have, for example, demonstrated that the epithelium is the main source of eotaxin-3 chemokines (25), certainly responsible for the chemoattraction of eosinophils.…”

“…As such, the permeability, the elasticity, the integrity of the esophagus may contribute to EE disease pathogenesis. Epithelial cells are highly hyperplastic in EE patients (56). Several external factors are known to increase basal cell expansion, such as gastric acid content in GERD disease.…”

Eosinophil oesophagitis étrendi és gyógyszeres vonatkozásai

“…A genetikai meghatározottságot bizonyítja az EoE családi halmozó-dása: Noel és mtsai 103 gyermeket vizsgáltak, a betegek 6,8%-ának családi anamnézisében volt kimutatható dysphagia. Beteg egyének testvéreiben a betegség kialakulási kockázata közel 80-szoros az átlagpopulációhoz képest [11]. Az EoE-val összefüggésbe hozható gének: az EoEben fokozott expressziót mutató CCL26/eotaxin-3 gén, valamint az 5. kromoszóma hosszú karján elhelyezkedő TSLP és WD36 gének.…”

Acalasia de esôfago e esofagite eosinofílica

“…Additionally pH measurements reveal a tendency to high pH values. 4 Diagnosis is made by biopsy which will reveal the presence of eosinophils in the lower third of the esophagus with numbers greater than 20 or 24 per 40-times magnification field. In general it will progress to more serious motility disorders and the presentation of odynophagia, food impaction, weight loss, failure to thrive and cachexia.…”

“…In general it will progress to more serious motility disorders and the presentation of odynophagia, food impaction, weight loss, failure to thrive and cachexia. [2][3][4] Despite being more often associated with esophageal wall thickening and stenosis, the association between esophageal achalasia and an eosinophilic esophagitis has been described. 2,5 In a series of 42 patients with diagnoses of esophageal achalasia, subjected to thoracic esophagectomy, with esophageal fragments studied microscopically, 22 patients (52%) presented eosinophila in the muscular layer.…”