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(Children or kids or pediatric) eosinophilic esophagitis

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https://www.readbyqxmd.com/read/29133286/eosinophilic-esophagitis-update-on-management-and-controversies
#1
REVIEW
Joan W Chen, John Y Kao
Eosinophilic esophagitis is a chronic allergen driven immune mediated disease that is increasingly recognized as a leading cause of dysphagia and foregut symptoms in children and adults. Much knowledge has been gained in recent years on the genetic and environmental risk factors for this disease, the associated inflammatory milieu, and the long term complications from esophageal remodeling. In this review we will highlight recent progress made in research into this disease, focusing on adults. We will discuss ongoing efforts to develop a minimally invasive technique that may obviate the need for repeated endoscopic assessment of disease activity...
November 13, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29129581/eoe-genetic-susceptibility-is-mediated-by-synergistic-interactions-between-eoe-specific-and-general-atopic-disease-loci
#2
L J Martin, H He, M H Collins, J P Abonia, J M Biagini Myers, M Eby, H E Johansson, L C Kottyan, G K Khurana Hershey, M E Rothenberg
BACKGROUND: Eosinophilic esophagitis (EoE) is an esophageal inflammatory disease associated with atopic diseases. TSLP and CAPN14 genetic variation contribute to EoE, but how this relates to atopy is unclear. The purpose of this study was to explore the relationship between EoE, atopy and genetic risk. METHODS: EoE-atopy enrichment was tested using 700 EoE cases and 801 community controls. Probing 372 SNPs in 63 atopy-genes, we evaluated EoE associations using 412 non-atopic and 868 atopic disease controls...
November 9, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29129303/endoscopic-treatment-of-eosinophilic-esophagitis
#3
REVIEW
Joel E Richter
In eosinophilic esophagitis, the main cause of solid-food dysphagia is tissue remodeling resulting in strictures and narrowed esophagus. Endoscopy and biopsies help to identify the degree of inflammation but often miss the fibrosis. Although initially considered dangerous, esophageal dilation has evolved into an extremely effective and safe treatment in fibrostenotic disease. The key is starting low with small-diameter bougies or balloons, and gradually dilating the esophagus and strictures to 16 to 18 mm. Results in more than 1000 adults and children have shown low rates of complications, especially perforations, and no deaths, but postprocedure chest pain is common...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129300/eosinophilic-esophagitis-in-children-and-adults
#4
REVIEW
Jonathan E Markowitz, Steven B Clayton
Adults and children with eosinophilic esophagitis (EoE) have distinct clinical and endoscopic presentations. Recognition of clinical signs, along with laboratory and endoscopic findings, is critical for the identification of patients with EoE because delay in diagnosis has been associated with esophageal remodeling and stricture formation. Clinical presentation varies considerably between adults and children. This is less due to differences in the disease and more due to patient differences. This article describes the similarities and differences in clinical presentation of children and adults with EoE, including areas of epidemiology, clinical and endoscopic presentation, pathophysiology, and treatment...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129298/latest-insights-on-the-relationship-between-symptoms-and-biologic-findings-in-adults-with-eosinophilic-esophagitis
#5
REVIEW
Ekaterina Safroneeva, Alex Straumann, Alain M Schoepfer
Patients with eosinophilic esophagitis (EoE) present with symptoms accompanied by behavioral adaptions to living with this condition. These include swallowing- and nonswallowing-associated pain in adulthood. In children, EoE symptoms vary with age and include vomiting, abdominal pain, and dysphagia. Studies using validated patient-reported outcome measures have demonstrated that symptoms in EoE are associated with severe biologic alterations and that patients on the low biologic severity spectrum have few symptoms...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129297/demographic-features-of-eosinophilic-esophagitis
#6
REVIEW
Anna Maria Lipowska, Robert T Kavitt
Eosinophilic esophagitis (EoE) is an increasingly prevalent chronic condition characterized by eosinophilic infiltration of the esophageal epithelium accompanied by esophageal symptoms. The number of new diagnoses is growing worldwide in both pediatric and adult populations. Differences in disease distribution and presentation have been found, varying by gender, race, and other characteristics. This review examines the existing literature and provides insight into the demographic features of EoE.
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129296/eosinophilic-esophagitis-incidence-and-prevalence
#7
REVIEW
Fouad J Moawad
Eosinophilic esophagitis (EoE) is a rapidly emerging allergy-mediated condition encountered frequently in clinical practice. It presents with failure to thrive, nausea, and vomiting in children and is a common reason for dysphagia and food impaction in adults. Several institution-based and population-based studies have reported the frequency of EoE over the past few years. The incidence and prevalence of EoE vary depending on the method of data collection. In population-based studies using national registries, the incidence appears to be increasing, currently estimated to be approximately 10 cases/100,000 persons annually, whereas the prevalence is reported between 10 and 57 cases/100,000 persons...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29127996/highlights-in-immune-response-microbiome-and-precision-medicine-in-allergic-disease-and-asthma
#8
EDITORIAL
Milena Sokolowska, Cezmi A Akdis
Several recent key findings in immunology of allergic diseases that have led to a need of reassessment of our current thinking are reviewed in this issue of the journal. Recently developed strong evidence on the role of hygiene hypothesis in protection from allergic disease and its immune mechanisms is reviewed by Ober et al. The authors pointed out immunologic mechanisms of lower prevalence of asthma and allergic sensitization observed among Amish children living on traditional farms with higher endotoxin levels as compared to Hutterite children living on industrialized farms...
October 2017: Current Opinion in Immunology
https://www.readbyqxmd.com/read/29121691/-eosinophilic-esophagitis-update-new-guidelines-of-the-european-study-group-eureos
#9
Stephan Miehlke, Christoph Schlag, Martin Storr, Ulrike von Arnim
Eosinophilic esophagitis is now considered to be a frequent chronic esophageal disease and is one of the most common causes for dysphagia and bolus obstruction in children and adults. The increasing significance and new scientific insights in this disorder required an update of currently existing guidelines. Therefore, the European Study Group of Eosinophilic Esophagitis (EUREOS) has elaborated new guidelines for the management of eosinophilic esophagitis, based on a systematic literature search and, for the first time, using the GRADE methodology (Grading of Recommendations Assessment, Development, and Evaluation)...
November 9, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29112859/translation-and-cultural-adaptation-of-the-pediatric-eosinophilic-esophagitis-symptom-score-peess-v2-0
#10
Maria Fernanda Oliveira Santos, Cristina Palmer Barros, Carlos Henrique Martins da Silva, Helena Borges Martins da Silva Paro
OBJECTIVES: To translate and culturally adapt the Pediatric Eosinophilic Esophagitis Symptom Score (version 2.0), a tool used to assess pediatric eosinophilic esophagitis symptoms reported by patients and/or their parents/caregivers. METHODS: The Pediatric Eosinophilic Esophagitis Symptom Score was translated through the following stages: initial translation, back-translation, and consensus of independent reviewers through the Delphi technique. The pre-final version of the Pediatric Eosinophilic Esophagitis Symptom Score was applied to five 8-to-18-year-old patients and to ten parents of two-to-18-year-old patients from an outpatient pediatric gastroenterology service (pre-test)...
November 4, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/29109046/when-should-infants-with-cow-s-milk-protein-allergy-use-an-amino-acid-formula-a-practical-guide
#11
Rosan Meyer, Marion Groetch, Carina Venter
Cow's milk protein allergy (CMPA) is the most common food allergy in childhood and its prevalence ranges between 1.9% and 4.9%. Most children present with CMPA at age less than 1 year and therefore may require a hypoallergenic formula in the absence of breast milk. Hypoallergenic formulas include both extensively hydrolyzed formula (EHF) and amino acid formula (AAF). For most children with a CMPA, an EHF will be sufficient for symptom resolution, as reflected in current guidelines, but there is a subset of children with CMPA where an AAF may be indicated...
November 3, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29104849/current-concepts-in-eosinophilic-esophagitis
#12
REVIEW
Dagmar Simon, Alex Straumann, Alain M Schoepfer, Hans-Uwe Simon
Background: Eosinophilic esophagitis (EoE) is a disease entity first described in the 1990s, but showing an increasing incidence that is characterized clinically by esophageal dysfunction and histologically by a striking eosinophil infiltration. Methods: This article discusses new aspects of the pathogenesis, symptoms, diagnosis, and treatment of EoE. Results: EoE affects both children and adults and is frequently associated with atopic disease and IgE sensitization...
2017: Allergo Journal International
https://www.readbyqxmd.com/read/29094023/absence-of-esophageal-eosinophilia-in-a-toddler-with-severe-eosinophilic-esophagitis
#13
Wenyin Loh, Karen Michelle Wright, Fang Kuan Chiou
Eosinophilic esophagitis (EoE) is a clinicopathologic disease characterised by esophageal dysfunction and eosinophil-predominant inflammation. Diagnosing EoE in children is particularly challenging as they tend to present with nonspecific symptoms and their mucosal specimens may have less than the threshold number of eosinophils. Reluctance to subject children to multiple endoscopic procedures and anesthesia often results in treatment with a proton pump inhibitor (PPI) first to evaluate clinical response. This approach presents a problem as a diagnosis of EoE may be missed...
October 2017: Asia Pacific Allergy
https://www.readbyqxmd.com/read/29074457/step-up-empiric-elimination-diet-for-pediatric-and-adult-eosinophilic-esophagitis-the-2-4-6-study
#14
Javier Molina-Infante, Ángel Arias, Javier Alcedo, Ruth Garcia-Romero, Sergio Casabona-Frances, Alicia Prieto-Garcia, Ines Modolell, Pedro L Gonzalez-Cordero, Isabel Perez-Martinez, Jose Luis Martin-Lorente, Carlos Guarner-Argente, Maria L Masiques, Victor Vila-Miravet, Roger Garcia-Puig, Edoardo Savarino, Carlos Teruel Sanchez-Vegazo, Cecilio Santander, Alfredo J Lucendo
BACKGROUND: Numerous dietary restrictions and endoscopies limit the implementation of empiric elimination diets in eosinophilic esophagitis (EoE). Milk and wheat/gluten are the most common food triggers. OBJECTIVE: To assess the effectiveness of a step-up dietary strategy for EoE. METHODS: Prospective study conducted in 14 centers. Patients underwent a 6-week two-food group elimination diet (TFGED) (milk and gluten-containing cereals). Remission was defined by symptom improvement and <15 eos/HPF...
October 23, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29062584/adrenal-insufficiency-in-pediatric-eosinophilic-esophagitis-patients-treated-with-swallowed-topical-steroids
#15
Stephanie Hsu, Colleen Wood, Zhaoxing Pan, Haseeb Rahat, Philip Zeitler, David Fleischer, Calies Menard-Katcher, Glenn T Furuta, Dan Atkins
Swallowed topical steroids (STS) are the only effective pharmacological therapy for eosinophilic esophagitis (EoE). Thus far, studies of small populations of EoE patients have reported conflicting results in relation to adrenal insufficiency (AI). We sought to measure AI in a clinical setting in children taking STS for EoE. We performed a quality improvement study of pediatric EoE patients seen in a multidisciplinary clinic, who were treated with STS for at least 3 months. Two hundred twenty-five patients completed questionnaires to assess for signs of AI...
September 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/29048518/disease-related-predictors-of-health-related-quality-of-life-in-youth-with-eosinophilic-esophagitis
#16
Mary K Lynch, Margaux J Barnes, Reed A Dimmitt, Lisa Martin, Marc E Rothenberg, Burel R Goodin
Objective: To evaluate relations between health-related quality of life (HRQoL) and clinical symptom presentation in youth with eosinophilic esophagitis (EoE). We hypothesized that presence of dysphagia, reflux, nausea/vomiting, and epigastric pain would be related to poorer HRQoL. In predictive models, it was hypothesized that dysphagia, reflux, nausea/vomiting, and epigastric pain would each significantly and uniquely predict poorer HRQoL. Methods: This cross-sectional, two-study design included 91 dyads comprised children with EoE and their respective caregivers across two tertiary children's hospitals, Site 1 in the Midwest (N = 47) and Site 2 in the Deep South (N = 44)...
October 12, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29048495/evidence-of-disturbed-sleep-in-children-with-eosinophilic-esophagitis-and-persistent-epigastric-pain
#17
Mary K Lynch, Reed A Dimmitt, Burel R Goodin
Objective: To determine whether the experience of persistent epigastric pain is associated with sleep disturbances in children with eosinophilic esophagitis (EoE). We hypothesized that children with EoE and persistent epigastric pain would (1) self-report greater current and worst pain severity, and (2) experience more disturbed sleep on objective and subjective measures in comparison with children with EoE but no persistent pain and healthy children. Methods: Fifty children with EoE were recruited for this cross-sectional study, of which 24 (48%) reported experiencing persistent epigastric pain...
September 15, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29043074/recent-advances-in-eosinophilic-esophagitis
#18
REVIEW
Sandy Durrani, Marc Rothenberg
Eosinophilic esophagitis is a chronic, antigen-driven, eosinophil-predominant inflammatory disease of the esophagus and affects both children and adults. Cutting-edge technologies, such as genome-wide association studies, have advanced our understanding of the disease pathogenesis at a remarkable rate. Recent insights from genetic and mechanistic studies have concluded that a complex interplay between genetic and environmental risk factors, allergic sensitization, and esophageal-specific pathways leads to disease pathogenesis...
2017: F1000Research
https://www.readbyqxmd.com/read/29039850/systematic-review-disease-activity-indices-in-eosinophilic-esophagitis
#19
REVIEW
Marijn J Warners, Pieter Hindryckx, Barrett G Levesque, Claire E Parker, Lisa M Shackelton, Reena Khanna, William J Sandborn, Geert R D'Haens, Brian G Feagan, Albert J Bredenoord, Vipul Jairath
OBJECTIVES: There is no clear consensus regarding the most appropriate measure(s) of eosinophilic esophagitis (EoE) disease activity. We aimed to identify all scoring indices used for the measurement of disease activity in EoE, appraise their operating properties, and discuss their value as outcome measures. METHODS: MEDLINE, EMBASE, and CENTRAL (The Cochrane library) were searched from inception to 11 May 2016. Randomized controlled trials (RCTs), cohort, case-control, and cross-sectional studies that reported outcomes to measure EoE disease activity or response to treatment were eligible...
November 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29029802/early-life-environmental-exposures-interact-with-genetic-susceptibility-variants-in-pediatric-patients-with-eosinophilic-esophagitis
#20
Elizabeth T Jensen, Jonathan T Kuhl, Lisa J Martin, Carl D Langefeld, Evan S Dellon, Marc E Rothenberg
BACKGROUND: Although eosinophilic esophagitis (EoE) is associated with certain gene variants, the rapidly increasing incidence of EoE suggests that environmental factors contribute to disease development. OBJECTIVE: We tested for gene-environment interaction between EoE-predisposing polymorphisms (within TSLP, LOC283710/KLF13, CAPN14, CCL26, and TGFB) and implicated early-life factors (antibiotic use in infancy, cesarean delivery, breast-feeding, neonatal intensive care unit [NICU] admission, and absence of pets in the home)...
September 12, 2017: Journal of Allergy and Clinical Immunology
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