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Eosinophilic gastrointestinal disorder

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https://www.readbyqxmd.com/read/28725075/eosinophilic-esophagitis-leaky-gullet-or-leaky-gut
#1
David A Katzka
Eosinophilic esophagitis (EoE) is a food allergen disorder driven by antigen recognition in the gastrointestinal tract. The study by Warners et al., strongly supports the esophageal epithelium as the area of disturbed permeability and primary target for initiation of the TH2-induced allergic pathway. In contrast, small bowel assessment reveals a lack of clear change in aspects of permeability compared to controls. It is not clear, however, if the available testing used for this purpose accurately assesses the mechanisms by which antigen recognition may occur in this organ...
July 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28682046/upper-gastrointestinal-conditions-nonmalignant-conditions-of-the-esophagus
#2
David S Estores, Ku-Lang Chang
Eosinophilic esophagitis (EE) is an allergic disorder of the esophagus. This diagnosis requires the presence of specific symptoms and a significantly elevated number of eosinophils in the esophageal lining as determined by endoscopic biopsies. Symptoms tend to be nonspecific among patients younger than 15 years. Among adults, dysphagia is the most common symptom. Comanagement with a gastroenterology subspecialist is essential, particularly for EE patients with a stricture. EE is commonly misdiagnosed as gastroesophageal reflux disease (GERD)...
July 2017: FP Essentials
https://www.readbyqxmd.com/read/28681569/diagnostic-use-of-endoscopic-full-thickness-wall-resection-eftr-a-novel-minimally-invasive-technique-for-colonic-tissue-sampling-in-patients-with-severe-gastrointestinal-motility-disorders
#3
P V Valli, D Pohl, M Fried, R Caduff, P Bauerfeind
BACKGROUND: Complex gastrointestinal (GI) motility disorders such as chronic intestinal pseudo-obstruction (CIPO) or Hirschsprung's disease (HD) are challenging to diagnose and treat appropriately. Thorough assessment of patient history, radiographic exams, endoscopy, and motility measurements aid in diagnostic workup, yet underlying histology is the cornerstone to enable a more distinct diagnosis of neuromuscular GI disorders. Traditionally, surgical procedures have been performed to obtain specimen suitable for accurate histologic analysis...
July 6, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28676207/effects-of-allergen-sensitization-on-response-to-therapy-in-children-with-eosinophilic-esophagitis
#4
Robert D Pesek, Mallikarjuna Rettiganti, Erin O'Brien, Sarah Beckwith, Caroline Daniel, Chunqiao Luo, Amy M Scurlock, Peggy Chandler, Rebecca A Levy, Tamara T Perry, Joshua L Kennedy, Sheva Chervinskiy, Maryelle Vonlanthen, Helen Casteel, Stephen C Fiedorek, Troy Gibbons, Stacie M Jones
BACKGROUND: In children with eosinophilic esophagitis (EoE) foods are the most common disease triggers, but environmental allergens are also suspected culprits. OBJECTIVE: To determine the effects of environmental allergen sensitization on response to treatment in children with EoE in the southeastern United States. METHODS: Patients 2 to 18 years old who were referred to the Arkansas Children's Hospital Eosinophilic Gastrointestinal Disorders Clinic from January 2012 to January 2016 were enrolled in a prospective, longitudinal cohort study with collection of demographics, clinical symptoms, medical history, allergy sensitization profiles, and response to treatment over time...
July 1, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28675283/-eosinophilic-gastrointestinal-disorders
#5
Konstantin Burgmann, Christophe Brunel, Christine Sempoux, Camillo Ribi, Sébastien Godat, Darius Moradpour, Alain M Schoepfer
The term « eosinophilic gastrointestinal disorders » describes a group of diseases that comprises eosinophilic esophagitis, gastritis, enteritis, and colitis. Eosinophilic esophagitis is the most prevalent form while eosinophilic gastritis, enteritis, and colitis are rare. Food antigens have increasingly been found to trigger the inflammatory response. This review will highlight the epidemiology, clinical manifestations, diagnostic modalities and therapeutic options of eosinophilic gastritis, enteritis, and colitis...
August 31, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28652675/eosinophilic-myocarditis-and-hypereosinophilic-syndrome
#6
Hanane Boussir, Amine Ghalem, Nabila Ismaili, Noha El Ouafi
Hypereosinophilic syndrome (HES) is a heterogeneous group of hematological disorders characterized by a chronic, unexplained hypereosinophilia with tissue damage. Cardiac involvement occurs in ∼20% of patients with HES and represents a major turning point. Cardiac injuries related to eosinophilia are divided into three chronological phases: eosinophilic infiltration, thrombosis, and fibrosis. We report a case of a 33-year-old woman diagnosed with HES, with pulmonary and gastrointestinal involvement and eosinophilic myocarditis in cardiogenic shock...
July 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28607327/m%C3%A3-n%C3%A3-trier-s-disease-as-a-gastrointestinal-manifestation-of-active-cytomegalovirus-infection-in-a-22-month-old-boy-a-case-report-with-a-review-of-the-literature-of-korean-pediatric-cases
#7
Jeana Hong, Seungkoo Lee, Yoonjung Shon
Ménétrier's disease (MD), which is characterized by hypertrophic gastric folds and foveolar cell hyperplasia, is the most common gastrointestinal (GI) cause of protein-losing enteropathy (PLE). The clinical course of MD in childhood differs from that in adults and has often been reported to be associated with cytomegalovirus (CMV) infection. We present a case of a previously healthy 22-month-old boy presenting with PLE, who was initially suspected to have an eosinophilic GI disorder (EGID). However, he was eventually confirmed, by detection of CMV DNA using polymerase chain reaction (PCR) with gastric tissue, to have MD associated with an active CMV infection...
June 13, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28603057/prevalence-of-eosinophilic-gastroenteritis-and-colitis-in-a-population-based-study-from-2012-to-2017
#8
Emad Mansoor, Mohannad Abou Saleh, Gregory S Cooper
BACKGROUND & AIMS: Although eosinophilic esophagitis (EoE) has been extensively studied, there have been few epidemiology studies of other eosinophilic gastrointestinal disorders (EGIDs). Using a large, population-based database, we investigated epidemiologic features of eosinophilic gastroenteritis (EoGE), and colitis (EoC) in the United States (US). METHODS: We collected data from a commercial database (Explorys Inc, Cleveland, OH) that provided electronic health records from 26 major integrated US healthcare systems from 1999 to March 2017...
June 8, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28596692/diagnosis-of-eosinophilic-gastroenteritis-is-easily-missed
#9
Kodjo-Kunale Abassa, Xian-Yi Lin, Jie-Ying Xuan, Hao-Xiong Zhou, Yun-Wei Guo
AIM: To analyze the clinical characteristics of eosinophilic gastroenteritis (EGE) and to investigate the situations of missed diagnosis of EGE. METHODS: First, the clinical characteristics of 20 EGE patients who were treated at our hospital were retrospectively summarized. Second, 159 patients who underwent gastroscopy and 211 patients who underwent colonoscopy were enrolled. The pathological diagnosis showed only chronic inflammation in their medical records. The biopsy slides of these patients were reevaluated to determine the number of infiltrating eosinophils in order to assess the probability of a missed diagnosis of EGE...
May 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28526277/gene-expression-patterns-in-distinct-endoscopic-findings-for-eosinophilic-gastritis-in-children
#10
Masamichi Sato, Tetsuo Shoda, Hirotaka Shimizu, Kanami Orihara, Kyoko Futamura, Akio Matsuda, Yoshiyuki Yamada, Rie Irie, Takako Yoshioka, Toshiaki Shimizu, Yukihiro Ohya, Ichiro Nomura, Kenji Matsumoto, Katsuhiro Arai
BACKGROUND: Eosinophilic gastritis (EG) is clinicopathologically characterized by both marked gastric eosinophilia and clinical symptoms. The endoscopic findings in EG vary among patients, leading to clinical confusion. However, little is known about the relationship between precise endoscopic findings and the pathophysiological process responsible for EG. OBJECTIVE: We aimed to elucidate whether the gross endoscopic findings of EG can be classified into distinct gene expression profiles...
May 16, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28515291/differential-disease-susceptibility-in-experimentally-reptarenavirus-infected-boa-constrictors-and-ball-pythons
#11
Mark D Stenglein, David Sanchez-Migallon Guzman, Valentina E Garcia, Marylee L Layton, Laura L Hoon-Hanks, Scott M Boback, M Kevin Keel, Tracy Drazenovich, Michelle G Hawkins, Joseph L DeRisi
Inclusion body disease (IBD) is an infectious disease originally described in captive snakes. It has traditionally been diagnosed by the presence of large eosinophilic cytoplasmic inclusions, and is associated with neurological, gastrointestinal and lymphoproliferative disorders. Previously, we identified and established a culture system for a novel lineage of arenaviruses isolated from boa constrictors diagnosed with IBD. Although ample circumstantial evidence suggested that these viruses, now known as reptarenaviruses, cause IBD, there has been no formal demonstration of disease causality since their discovery...
May 17, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28502433/eosinophilic-gastrointestinal-disorders
#12
REVIEW
Lisa M Fahey, Chris A Liacouras
Eosinophilic esophagitis (EoE) is an atopic disease that is characterized by an isolated infiltration of eosinophils into the epithelium of the esophagus and is triggered by specific allergens. Patients should undergo an upper endoscopy with biopsy after 6 to 8 weeks of treatment with a proton pump inhibitor in order to make the diagnosis of EoE. Eosinophilic gastroenteritis is a pathologic eosinophilic infiltration of any portion of the gastrointestinal tract, and eosinophilic proctocolitis is an eosinophilic infiltration in the colon alone...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28475723/stigma-perceptions-in-patients-with-eosinophilic-gastrointestinal-disorders
#13
L Guadagnoli, T H Taft, L Keefer
This study aims to evaluate the presence of perceived stigma in people diagnosed (self-reported) with an eosinophilic gastrointestinal disorder and examine the relationship to the patient's health-related quality of life and additional psychosocial patient-reported outcomes. One hundred forty-nine patients diagnosed for a minimum of 6 months participated in the study. Eligible participants completed questionnaires to assess perceived stigma, psychological functioning, and health-related quality of life. Perceived stigma was moderately associated with a decrease in total health-related quality of life and perceived treatment efficacy...
July 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28429201/how-to-approach-lymphocytic-esophagitis
#14
REVIEW
Anh D Nguyen, Kerry B Dunbar
PURPOSE OF REVIEW: Lymphocytic esophagitis (LE) is an unusual esophageal condition defined by an increased number of lymphocytes in the esophageal epithelium. With few published studies of LE available, it is unclear whether LE is a truly distinct clinical entity or a histological manifestation of other known gastrointestinal disorders. This review summarizes recent studies of lymphocytic esophagitis. RECENT FINDINGS: Studies have suggested that LE may be related to eosinophilic esophagitis (EoE) or a manifestation of gastroesophageal reflux disease (GERD)...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28428721/proposed-criteria-to-differentiate-heterogeneous-eosinophilic-gastrointestinal-disorders-of-the-esophagus-including-eosinophilic-esophageal-myositis
#15
Hiroki Sato, Nao Nakajima, Kazuya Takahashi, Go Hasegawa, Ken-Ichi Mizuno, Satoru Hashimoto, Satoshi Ikarashi, Kazunao Hayashi, Yutaka Honda, Junji Yokoyama, Yuichi Sato, Shuji Terai
AIM: To define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus. METHODS: Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis (EoE), subepithelial eosinophilic esophagitis (sEoE) and eosinophilic esophageal myositis (EoEM), identified by endoscopy, manometry and serum immunoglobulin E levels (s-IgE), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28390860/basophil-derived-il-4-promotes-epicutaneous-antigen-sensitization-concomitant-with-the-development-of-food-allergy
#16
Maryam Hussain, Loïc Borcard, Kevin P Walsh, Maria Pena Rodriguez, Christoph Mueller, Brian S Kim, Masato Kubo, David Artis, Mario Noti
BACKGROUND: Exaggerated thymic stromal lymphopoietin (TSLP) production and infiltration of basophils are associated with the pathogenesis of atopic dermatitis (AD), a recognized risk factor for the development of food allergies. Although TSLP and basophils have been implicated in promotion of food-induced allergic disorders in response to epicutaneous sensitization, the mechanisms by which TSLP-elicited basophils guide the progression of allergic inflammation in the skin to distant mucosal sites, such as the gastrointestinal tract, are poorly understood...
April 6, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28370248/the-pathology-and-causes-of-tissue-eosinophilia-in-the-gastrointestinal-tract
#17
REVIEW
James R Conner, Richard Kirsch
Eosinophilic inflammation in the gastrointestinal tract may occur as a primary eosinophilic disorder or as a secondary response with other causes. Primary eosinophilic gastrointestinal disorders (EGIDs) are Th2-mediated allergic diseases that overlap pathogenetically with atopic conditions involving other organs. The pathological diagnosis of primary EGIDs can be challenging, as the quantity of eosinophils considered to be 'abnormal' is difficult to define, and the diagnosis, by definition, requires exclusion of the far more common secondary causes...
March 31, 2017: Histopathology
https://www.readbyqxmd.com/read/28338484/the-importance-of-biopsy-sampling-practices-in-the-pathologic-evaluation-of-gastrointestinal-disorders
#18
Nicole C Panarelli, Rhonda K Yantiss
PURPOSE OF REVIEW: To summarize the literature regarding appropriate endoscopic sampling and surveillance protocols for common inflammatory diseases of the digestive tract. Gastroenterologists increasingly use endoscopy with mucosal biopsy to detect inflammatory diseases, assess response to therapy, and monitor for progression to dysplasia. RECENT FINDINGS: Many diseases show a patchy distribution in the digestive tract and there may be poor correlation between the endoscopic appearance and presence of histologic abnormalities...
September 2016: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28326599/functional-dyspepsia-is-associated-with-duodenal-eosinophilia-in-an-australian-paediatric-cohort
#19
L Wauters, S Nightingale, N J Talley, B Sulaiman, M M Walker
BACKGROUND: The pathophysiology of functional dyspepsia (FD) remains unknown. Duodenal eosinophil infiltration has been reported. AIM: To assess the association between dyspeptic symptoms and duodenal eosinophilia in children undergoing upper gastrointestinal endoscopy. METHODS: In this retrospective cohort study, children with normal upper endoscopy and routine histology at a single tertiary paediatric centre between 2010 and 2014 were included...
May 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28283156/dietary-therapy-and-nutrition-management-of-eosinophilic-esophagitis-a-work-group-report-of-the-american-academy-of-allergy-asthma-and-immunology
#20
Marion Groetch, Carina Venter, Isabel Skypala, Berber Vlieg-Boerstra, Kate Grimshaw, Raquel Durban, Alison Cassin, Michelle Henry, Kara Kliewer, Lynda Kabbash, Dan Atkins, Anna Nowak-Węgrzyn, Mark Holbreich, Mirna Chehade
Eosinophilic esophagitis (EoE) is a chronic/immune-antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. Dietary elimination therapy has been shown to be an effective, drug-free prescription for the treatment of EoE. A range of different dietary elimination therapies have been used. Regardless of the elimination diet chosen, dietary therapy requires in-depth nutrition assessment and management. Elimination diets are not without risk and may impact nutritional status, eating pleasure, and overall quality of life...
March 2017: Journal of Allergy and Clinical Immunology in Practice
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