Pediatric patients with eosinophilic esophagitis: An 8-year follow-up

Assa’ad, Amal; Putnam, Philip E.; Collins, Margaret H.; Akers, Rachel; Jameson, Sean C.; Kirby, Cassie L.; Buckmeier, Bridget K.; Bullock, Jennifer Z.; Collier, Ann R.; Konikoff, Michael R.; Noel, Richard J.; Guajardo, Jesus R.; Rothenberg, Marc E.

doi:10.1016/j.jaci.2006.10.044

Cited by 306 publications

(240 citation statements)

References 21 publications

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“…Only one patient presented H. pylori gastritis. Another group reported 7 (7.8%) H. pylori infected patients among 89 patients with EoE (3) . It seems there is an inverse relationship between H. pylori and EoE, as well as with other allergic conditions (6) .…”

Section: Discussionmentioning

confidence: 98%

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: Discussionmentioning

confidence: 98%

Histological Features of Eosinophilic Esophagitis in Children and Adolescents

Carrasco

Machado

Patrı́cio

et al. 2017

Arq. Gastroenterol.

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“…These include atopy, typically seen in children up to 50-80%, allergic rhinitis, asthma, eczema, family history of atopy, elevated serum IgE level, peripheral blood eosinophilia, and positive allergy testing [32]. However these findings alone are not predictive of severity of eosinophilia [33].…”

Section: Clinical and Histopathologic Findingsmentioning

confidence: 99%

“…Since EoE is a chronic disease, relapse of symptoms after treatment cessation ranges from 45% -79% [32,51]. In a study by Straumann et al in 2011, patients given low-dose budesonide (swallowed budesonide 0.25 mg twice a day) compared to placebo showed more effective maintenance of histologic and clinical remission.…”

Section: Maintenance Of Therapymentioning

confidence: 99%

Eosinophilic Esophagitis–More than Two Decades of Progress

Rahimi

Ertan

2015

JGPLD

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“…GI symptoms: Eosinophilic oesophagitis presents with abdominal pain, dysphagia, poor appetite, reflux and failure to thrive 11 . Both IgE mediated and nonIgE mediated mechanisms are responsible for eosinophilic infiltration of gastrointestinal tract 11 .…”

Section: Manifestations Of Mixed Ige and Non Ige Mediated Reactionsmentioning

confidence: 99%

“…Both IgE mediated and nonIgE mediated mechanisms are responsible for eosinophilic infiltration of gastrointestinal tract 11 .…”

Section: Manifestations Of Mixed Ige and Non Ige Mediated Reactionsmentioning

confidence: 99%