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https://www.readbyqxmd.com/read/28812459/alox15-immunohistochemistry-aids-in-the-diagnosis-of-eosinophilic-esophagitis-on-pauci-eosinophilic-biopsies-in-children
#1
Yiang Hui, Sonja Chen, Kara A Lombardo, Murray B Resnick, Shamlal Mangray, Andres Matoso
Histologically, esophageal biopsies should have ≥15 intraepithelial eosinophils (IEEs) per high power field (HPF) to support a clinicopathologic diagnosis of eosinophilic esophagitis (EoE). Children with clinically apparent EoE may show pauci-eosinophilic biopsies due to patchy involvement. Immunostaining (Immunohistochemistry) for arachidonate-15 lipooxygenase (ALOX15) has been demonstrated to be a sensitive marker for EoE. We retrospectively assessed the expression of ALOX15 in 48 biopsies from 21 patients with established diagnosis of EoE and with tissue fragments below the threshold of 15 IEEs/HPF...
September 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28809387/accuracy-and-safety-of-the-cytosponge-for-assessing-histologic-activity-in-eosinophilic-esophagitis-a-two-center-study
#2
David A Katzka, Thomas C Smyrk, Jeffrey A Alexander, Debra M Geno, RoseMary A Beitia, Audrey O Chang, Nicholas J Shaheen, Rebecca C Fitzgerald, Evan S Dellon
OBJECTIVES: Management of eosinophilic esophagitis (EoE) requires repeated endoscopic mucosal sampling to assess disease activity. A less invasive and expensive means of monitoring of EoE is required. The objective of this study was to assess the accuracy, safety, and tolerability of the cytosponge compared to endoscopy and biopsy for histologic assessment of EoE. METHODS: In this prospective two-center cross-sectional study, patients with known EoE underwent cytosponge sampling followed by endoscopy and biopsy...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28803528/the-role-of-endoscopy-in-eosinophilic-esophagitis-from-diagnosis-to-therapy
#3
Alfredo J Lucendo, Ángel Arias, Javier Molina-Infante, Laura Arias-González
Eosinophilic esophagitis (EoE) has arisen as a common disorder in current clinical and endoscopic gastroenterology practice. Areas covered: A comprehensive review of the literature to summarize and update different aspects related with the use of endoscopy in the diagnostic workout and treatment of pediatric and adult EoE patients is conducted. Expert commentary: Endoscopic features in EoE are frequently subtle, so were inadverted in some initial reports of the disease. Literature has described a wide number of EoE-associated features, systematized in the EREFS classification, which standardized the grade and severity of exudates, rings, edema, furrows, and strictures...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28774845/epidemiology-and-natural-history-of-eosinophilic-esophagitis
#4
Evan S Dellon, Ikuo Hirano
Eosinophilic esophagitis (EoE) has emerged over the past 2 decades as a major cause of upper gastrointestinal morbidity. Over this time, the epidemiology of EoE has also rapidly evolved. EoE has transformed from a rare case-reportable condition to disease that is commonly encountered in the gastroenterology clinic, hospital emergency room, and endoscopy suite. The incidence and prevalence are increasing at rates that outpace increased disease recognition. Current incidence estimates range from 5 to 10 cases per 100,000, and current prevalence estimates range from 0...
July 31, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28770203/clinical-applications-of-the-eosinophilic-esophagitis-diagnostic-panel
#5
REVIEW
Ting Wen, Marc E Rothenberg
Eosinophilic esophagitis (EoE) is a recently recognized upper gastrointestinal allergic disorder characterized by esophageal dysfunction (e.g., dysphagia) and esophageal eosinophilia of ≥15 eosinophils/high-power field in patients who have persistent esophagitis even on proton pump inhibitor (PPI) therapy. The histologic method is the gold standard of EoE diagnosis. However, EoE clinical symptoms do not always correlate with histology, and the histologic method has sensitivity and specificity issues due to the patchiness of EoE and the subjective nature of the method...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28757265/pathophysiology-of-eosinophilic-esophagitis
#6
Kelly M O'Shea, Seema S Aceves, Evan S Dellon, Sandeep K Gupta, Jonathan M Spergel, Glenn T Furuta, Marc E Rothenberg
Eosinophilic esophagitis (EoE) is an emerging disease that is distinguished from gastroesophageal reflux disease (GERD) by the expression of a unique esophageal transcriptome and the interplay of early life environmental factors with distinct genetic susceptibility elements at 5q22 (TSLP) and 2p23 (CAPN14). Rare genetic syndromes have uncovered the contribution of barrier disruption, mediated in part by defective desmosomes and dysregulated transforming factor beta (TGF-β) production and signaling, to EoE pathophysiology...
July 27, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28756235/diagnosis-and-treatment-of-eosinophilic-esophagitis
#7
Alex Straumann, David A Katzka
Eosinophilic esophagitis (EoE) is a new disease. It is caused by a T-helper 2 cell response to food antigens in contact with the esophageal mucosa. Although no single feature defines EoE, a constellation of compatible demographic, clinical, endoscopic, and histologic findings establish the diagnosis. Children present with symptoms and endoscopic patterns characteristic of inflammation whereas adolescents and adults have manifestations of fibrosis and gross esophageal strictures. Clinical and endoscopic scoring systems have helped to standardize diagnosis...
July 26, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28745828/incidence-of-eosinophilic-esophagitis-in-the-netherlands-continues-to-rise-20-year-results-from-a-nationwide-pathology-database
#8
M J Warners, W de Rooij, B D van Rhijn, J Verheij, A H Bruggink, A J P M Smout, A J Bredenoord
BACKGROUND: The incidence of eosinophilic esophagitis (EoE) has increased rapidly. Most epidemiologic data were gathered in single-center studies over a short timeframe, possibly explaining the heterogeneous incidences. AIM: The aim of this study was to retrospectively estimate the Dutch nationwide incidence of EoE over the last 20 years. METHODS: The Dutch pathology registry (PALGA) was queried to identify pathology reports describing esophageal eosinophilia from 1996 to 2016...
July 26, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28728257/-eosinophilic-esophagitis-in-children-analysis-of-22-cases
#9
M F Sun, W Z Gu, K R Peng, M N Liu, X L Shu, L Q Jiang, M Z Jiang
Objective: Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease.The current domestic reports of EoE in children is rare.The aim of this study was to analyze the clinical features, the diagnosis and treatment advance of EoE in children by case analysis and literature review. Method: Clinical data of 22 children with EoE from January, 2011 to December, 2015 in Children's Hospital, Zhejiang University School of Medicine were recorded, retrospective analysis was performed on clinical presentation, gastroendoscopy and histopathological examination features and the treatment...
July 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28725075/eosinophilic-esophagitis-leaky-gullet-or-leaky-gut
#10
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/28721213/diagnostic-approaches-and-treatment-of-eosinophilic-esophagitis-a-review-article
#11
REVIEW
Hossein Akhondi
Eosinophilic Esophagitis (EoE) is a condition that involves eosinophilic influx into the esophageal epithelium. It affects both children and adults; Adults present with dysphagia whereas children with vague abdominal complaints. The clinical symptoms as well as pathologic features of EoE and gastro esophageal reflux disease (GERD) are similar. Since eosinophilia in the esophagus is a non-specific finding, the clinical presentation in conjunction with endoscopic findings and pathology, is crucial in determining a differential diagnosis...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28719593/long-term-treatment-of-eosinophilic-esophagitis-with-swallowed-topical-corticosteroids-development-and-evaluation-of-a-therapeutic-concept
#12
Thomas Greuter, Christian Bussmann, Ekaterina Safroneeva, Alain M Schoepfer, Luc Biedermann, Stephan R Vavricka, Alex Straumann
OBJECTIVES: Swallowed topical corticosteroids (STCs) are efficacious in inducing and presumably maintaining remission in patients with active eosinophilic esophagitis (EoE). Hitherto, it has not been evaluated whether long-lasting remission can be achieved, and whether treatment can be stopped once patients have achieved this remission. METHODS: Since 2007, EoE patients included into a large database at the Swiss EoE Clinics were put on STCs as induction/maintenance therapy...
July 18, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28712126/evidence-of-an-abnormal-epithelial-barrier-in-active-untreated-and-corticosteroid-treated-eosinophilic-esophagitis
#13
D Simon, B Page, M Vogel, C Bussmann, C Blanchard, A Straumann, H-U Simon
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated disease characterized by symptoms related to esophageal dysfunction and an eosinophil-predominant inflammation. This study has aimed to investigate whether the recently observed sensitization to Candida albicans in patients with EoE is owing to pre-existing disease and its underlying abnormal epithelial barrier or, alternatively, is linked to corticosteroid (CS) therapy. METHODS: Medical histories, as well as serum and tissue samples of 60 patients with EoE (15 CS naive, 45 with current or previous CS therapy) and 20 controls, stored in the Swiss Eosinophilic Esophagitis Database (SEED) and Biobank, were analyzed...
July 16, 2017: Allergy
https://www.readbyqxmd.com/read/28676207/effects-of-allergen-sensitization-on-response-to-therapy-in-children-with-eosinophilic-esophagitis
#14
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/28655543/health-related-quality-of-life-and-costs-associated-with-eosinophilic-esophagitis-a-systematic-review
#15
Vincent Mukkada, Gary W Falk, Christian S Eichinger, Denise King, Lora Todorova, Nicholas J Shaheen
BACKGROUND & AIMS: Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease characterized by esophageal inflammation and dysfunction. Little is known about the humanistic and economic burden of the disease on patients, their caregivers and the healthcare system. A systematic review was conducted to evaluate the existing literature on the disease burden of EoE for patients and their caregivers. METHODS: The MEDLINE, Embase and Evidence-Based Medicine Reviews databases and recent congresses were searched on 23 March 2017 for English-language publications describing the impact of EoE on health-related quality of life (HRQoL) in children and adults, and the economic burden associated with the disease...
June 24, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28655508/a-penetrating-look-at-eosinophilic-esophagitis-pathogenesis-direct-antigen-exposure-in-the-esophagus
#16
Hamish Philpott, Evan S Dellon
No abstract text is available yet for this article.
June 24, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28653125/eosinophilic-esophagitis-in-children
#17
REVIEW
Melanie A Ruffner, Jonathan M Spergel
PURPOSE OF REVIEW: EoE is a significant cause of gastrointestinal morbidity affecting 1:2000. Patients with EoE typically have multiple atopic comorbidities, and additionally, many patients with EoE can be controlled well with elimination diets. The purpose of this review is to summarize the care of pediatric eosinophilic esophagitis patients. RECENT FINDINGS: EoE represents a distinct clinical syndrome which is characterized by esophageal dysfunction and eosinophil-predominant inflammation of the esophageal mucosa...
August 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28652128/the-esophageal-epithelial-barrier-in-health-and-disease
#18
Christopher H Blevins, Prasad G Iyer, Marcelo F Vela, David A Katzka
Dysfunction in the esophageal epithelial barrier function is a major source for morbidity. In order to better understand the pathophysiologic pathways of the diseases associated with barrier dysfunction, including gastroesophageal reflux disease (GERD), eosinophilic esophagitis (EoE), Barrett's esophagus (BE) and obesity, it is important to understand the esophageal epithelial embryologic development, microscopic anatomy with a special focus on the barrier structure and function, extra-epithelial defense mechanisms and how these change in the diseased state...
June 23, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28644352/elevated-serum-tissue-transglutaminase-antibodies-in-children-with-eosinophilic-esophagitis
#19
Anna K Le Fevre, Marjorie M Walker, Amir Hadjiashrafy, Rani Bhatia, Joerg Mattes, Nicholas J Talley, Scott Nightingale
OBJECTIVES: This study compared the clinical and histopathological characteristics of children with eosinophilic esophagitis (EoE) and elevated anti-transglutaminase (TTG Ab) with those with EoE and normal TTG Ab titres. METHODS: Single-center chart and blinded histopathological review of patients diagnosed with EoE for a 4-year period, who had esophageal and duodenal biopsies taken at time of endoscopy, and TTG Ab measured within 6 months of biopsy. Patients with histology-proven CD were excluded...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28644351/adherence-to-celiac-disease-and-eosinophilic-esophagitis-biopsy-guidelines-is-poor-in-children
#20
Thomas Wallach, Robert M Genta, Benjamin Lebwohl, Peter H R Green, Norelle R Reilly
OBJECTIVES: Celiac disease (CD) and eosinophilic esophagitis (EoE) are underdiagnosed gastrointestinal conditions, which adversely affect children's health. Previous studies have shown that diagnostic guidelines for CD are not consistently followed in adults. The aims of the present study are to assess the frequency with which endoscopists comply with diagnostic guidelines for CD and EoE in children, and to determine whether an association exists between adherence to biopsy guidelines and disease detection in pediatric patients...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
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