Oral Administration of Cromolyn in a Patient With Protein-Losing Enteropathy, Food Allergy, and Eosinophilic Gastroenteritis

Dellen, Richard G. Van; Lewis, Jason

doi:10.1016/s0025-6196(12)61640-1

Cited by 59 publications

(19 citation statements)

References 11 publications

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“…Other allergy drugs have been trialed in EG with varying results, i.e., montelukast and sodium cromolyn have shown inconsistent results on sustaining remission of EG [143,153].…”

Section: Treatmentmentioning

confidence: 99%

Eosinophilic Esophagitis and Gastroenteritis

Cianferoni

Spergel

2015

Curr Allergy Asthma Rep

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Eosinophilic gastrointestinal disease (EGID) can be classified as eosinophilic esophagitis (EoE) when the eosinophilia is limited to the esophagus or as eosinophilic gastritis (EG) if it is limited to the gastric tract, eosinophilic colitis (EC) if it is limited to the colon, and eosinophilic gastroenteritis (EGE) if the eosinophilia involves one or more parts of the gastrointestinal tract. EoE is by far the most common EGID. It is a well-defined chronic atopic disease due to a T helper type 2 (Th2) inflammation triggered often by food allergens. EoE diagnosis is done if an esophageal biopsy shows at least 15 eosinophils per high power field (eos/hpf). Globally accepted long-term therapies for EoE are the use of swallowed inhaled steroids or food antigen avoidance. The treatment of EoE is done not only to control symptoms but also to prevent complications such as esophageal stricture and food impaction. EGE cause non-specific gastrointestinal (GI) symptoms and are diagnosed if esophagogastroduodenoscopy (EGD)/colonoscopy show eosinophilia in one or more parts of the GI tract. They are rare diseases with an unclear pathogenesis, and they are poorly defined in terms of diagnostic criteria and treatment. Before initiating treatment of any EGE, it is imperative to conduct a differential diagnosis to exclude other causes of hypereosinophilia with GI localization. EGE are often poorly responsive to therapy and there is no commonly accepted long-term treatment. EG has many characteristics similar to EoE, including the fact that it is often due to a food allergen-driven Th2 inflammation; transcriptome analysis however shows that it is more a systemic disease and has a different gene signature than EoE. EC is a benign form of delayed food allergy in infant and is instead a difficult-to-treat severe inflammatory condition in older children and adults. EC in the latter groups can be a manifestation of drug allergy or autoimmune disease. Overall EGE, EC, and EG are rare and are a diagnosis of exclusion until more common causes of eosinophilia have been excluded.

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“…Other allergy drugs have been trialed in EG with varying results, i.e., montelukast and sodium cromolyn have shown inconsistent results on sustaining remission of EG [143,153].…”

Section: Treatmentmentioning

confidence: 99%

Eosinophilic Esophagitis and Gastroenteritis

Cianferoni

Spergel

2015

Curr Allergy Asthma Rep

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“…Case reports have described patients who were successfully treated with sodium chromoglycate monotherapy [52][53][54]. No major side effects were observed with this class of medication [55].…”

Section: Sodium Chromoglycatementioning

confidence: 99%

The management of eosinophilic gastroenteritis

Gupta

Aggarwal

Gupta

et al. 2015

Scandinavian Journal of Gastroenterology

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Eosinophilic gastroenteritis (EG) is a rare disorder characterized by eosinophilic infiltration of the gastrointestinal tract. No medication at present is approved by the Food and drug administration of United States for the treatment of EG. The rarity of the disease limits our experience with the different management options. It also limits the ability to conduct randomized controlled trials that could clearly delineate the efficacy of new therapeutic agents. This review assesses the various management options that have been tried on patients with EG.

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“…Cromolyn sodium was reported to be effective in one adult with eosinophilic gastroenteritis with protein-losing enteropathy [39]. The use of montelukast demonstrated limited effectiveness in treating adults with eosinophilic esophagitis [40], and its use in children with various gastrointestinal eosinophilic diseases is limited to a case series reporting clinical improvement but lacking histological follow-up [41].…”

Section: Mast Cell Stabilizers and Leukotriene Inhibitorsmentioning

confidence: 99%