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https://www.readbyqxmd.com/read/27900765/the-role-of-the-otolaryngologist-in-the-evaluation-and-diagnosis-of-eosinophilic-esophagitis
#1
Mark Kubik, Prasad Thottam, Amber Shaffer, Sukgi Choi
OBJECTIVE: To describe the clinical presentation and role of the otolaryngologist in the evaluation of eosinophilic esophagitis (EoE) at a tertiary pediatric hospital. STUDY DESIGN: Retrospective review. METHODS: Records from pediatric patients with a diagnosis of EoE from 2003 to 2015 were reviewed. Study variables were analyzed to compare patients presenting to different specialties. RESULTS: Two hundred and fifty-one patients with EoE were evaluated...
November 30, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27896821/clinical-symptom-tool-that-raises-the-index-of-suspicion-for-eosinophilic-oesophagitis-in-adults-and-drives-earlier-biopsy-for-definitive-diagnosis
#2
U von Arnim, F-W Röhl, S Miehlke, D Jechorek, D Reinhold, T Wex, P Malfertheiner
BACKGROUND: Eosinophilic oesophagitis (EoE) and gastro-oesophageal reflux disease (GERD) present with overlapping symptomatology and it is challenging to distinguish EoE from GERD clinically before endoscopy. AIM: To investigate the prognostic value of a set of clinical symptoms and laboratory values in patients with EoE and GERD. METHODS: In this prospective, single-centre, observational study, we compared clinical and laboratory data from 202 patients with EoE or GERD (10 relevant characteristics)...
November 29, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27889574/budesonide-oral-suspension-improves-symptomatic-endoscopic-and-histologic-parameters-compared-with-placebo-in-patients-with-eosinophilic-esophagitis
#3
Evan S Dellon, David A Katzka, Margaret H Collins, Mohamed Hamdani, Sandeep K Gupta, Ikuo Hirano
BACKGROUND & AIMS: Pharmacologic treatment of eosinophilic esophagitis (EoE) is limited to off-label use of corticosteroids not optimized for esophageal delivery. We performed a randomized, controlled phase 2 trial to assess the ability of budesonide oral suspension (BOS), a novel muco-adherent topical steroid formulation, to reduce symptoms and esophageal eosinophilia in adolescents and adults with EoE. METHODS: In this multicenter, randomized, double-blind, placebo-controlled, parallel-group trial, 93 EoE patients between the ages of 11 and 40 years with dysphagia and active esophageal eosinophilia were randomized to receive either BOS 2 mg or placebo twice daily for 12 weeks...
November 23, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27878833/presence-of-intraepithelial-food-antigen-in-patients-with-active-eosinophilic-oesophagitis
#4
E V Marietta, D M Geno, T C Smyrk, A Becker, J A Alexander, M Camilleri, J A Murray, D A Katzka
BACKGROUND: Although eosinophilic oesophagitis (EoE) is putatively mediated by an abnormal response to food antigen, the oesophagus is considered relatively impermeable to large molecules. AIM: To assess whether food antigens penetrate the oesophageal mucosa in patients with EoE. METHODS: Anti-gliadin staining was performed in three groups: active EoE, inactive EoE and EoE patients on a low or gluten free diet. To appraise the specificity of our results, we also performed gliadin staining on six patients without oesophageal disease who were consuming gluten...
November 22, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27868307/effects-of-eosinophilic-oesophagitis-on-quality-of-life-in-an-adult-uk-population-a-case-control-study
#5
R Hewett, C Alexakis, A D Farmer, J Ainley, V Chhaya, J O Hayat, A Poullis, J-Y Kang
Eosinophilic oesophagitis (EoE) is a chronic immune-mediated esophageal disease, characterized by symptoms related to esophageal dysfunction and histologically by eosinophil predominant inflammation. Current evidence for an adverse impact on quality of life (QoL) is conflicting and there are no data from a UK population regarding QoL. We conducted a prospective cross-sectional observational study using the Short Form-36 Health Survey, Hospital Dysphagia/Odynophagia Questionnaire, and the EoE Adult Quality of Life Questionnaire to assess QoL and severity of dysphagia in EoE patients, compared to age and gender matched healthy control subjects...
November 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27868216/the-endoscopic-reference-score-shows-modest-accuracy-to-predict-either-clinical-or-histological-activity-in-adult-patients-with-eosinophilic-oesophagitis
#6
J Rodríguez-Sánchez, J Barrio-Andrés, O Nantes Castillejo, E Valdivieso-Cortazar, I Pérez-Martínez, A Boumidi, J A Olmos-Jérez, G Payeras-Llodra, N Alcaide-Suarez, L Ruiz-Rebollo, B Madrigal-Rubiales, E Gonzalez-Obeso, E de la Santa Belda, B López Viedma, J Molina-Infante
BACKGROUND: Conflicting results have been recently reported for the accuracy of the Endoscopic Reference Score (EREFS), an standardised endoscopic classification, to predict the histological activity of eosinophilic oesophagitis (EoE). AIM: To evaluate the accuracy of the EREFS to predict either histological or clinical activity of EoE. METHODS: Prospective multicentre study conducted in eight Spanish centres evaluating adult EoE patients, either naïve or after treatment...
November 20, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27824401/comparison-of-different-biopsy-forceps-models-for-tissue-sampling-in-eosinophilic-esophagitis
#7
Christian Bussmann, Alain M Schoepfer, Ekaterina Safroneeva, Nadine Haas, Sébastien Godat, Christine Sempoux, Hans-Uwe Simon, Alex Straumann
Background and aims: Eosinophilic esophagitis (EoE) is a mixed inflammatory and fibrostenotic disease. Unlike superficial inflammatory changes, subepithelial fibrosis is not routinely sampled in esophageal biopsies. This study aimed to evaluate the efficacy and safety of deep esophageal sampling with four different types of biopsy forceps. Patients and methods: In this cross-sectional study, esophageal biopsies were taken in 30 adult patients by one expert endoscopist. Biopsies sampled from distal esophagus using a static jaw forceps (Olympus, FB-11K-1) were compared with proximal biopsies sampled with static jaw (Olympus, FB-45Q-1), alligator jaw (Olympus, FB-210K), and large-capacity forceps (Boston Scientific, Radial Jaw 4)...
December 2016: Endoscopy
https://www.readbyqxmd.com/read/27821174/eosinophilic-esophagitis-after-congenital-diaphragmatic-hernia
#8
Amelia Licari, Riccardo Castagnoli, Gian Luigi Marseglia
BACKGROUND: Eosinophilic esophagitis (EoE) is an increasingly diagnosed disease, especially in the western world. Although its pathogenesis remains poorly understood, there is strong evidence that the eosinophilic inflammation in EoE is primarily triggered by immune dysregulation secondary to allergic sensitization to dietary or aero-allergens. Recent studies have reported a higher prevalence of EoE in children with congenital gastrointestinal malformations, i.e. esophageal atresia and/or tracheoesophageal fistula...
November 8, 2016: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/27778205/association-between-body-mass-index-and-clinical-and-endoscopic-features-of-eosinophilic-esophagitis
#9
W Asher Wolf, Nicholas A Piazza, Jessica H Gebhart, Spencer Rusin, Shannon Covey, Leana L Higgins, RoseMary Beitia, Olga Speck, Kimberly Woodward, Cary C Cotton, Thomas M Runge, Swathi Eluri, John T Woosley, Nicholas J Shaheen, Evan S Dellon
BACKGROUND: Because eosinophilic esophagitis (EoE) causes dysphagia, esophageal narrowing, and strictures, it could result in low body mass index (BMI), but there are few data assessing this. AIM: To determine whether EoE is associated with decreased BMI. METHODS: We conducted a prospective study at the University of North Carolina from 2009 to 2013 enrolling consecutive adults undergoing outpatient EGD. BMI and endoscopic findings were recorded...
October 24, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27766109/adrenal-suppression-in-children-treated-with-swallowed-fluticasone-and-oral-viscous-budesonide-for-eosinophilic-esophagitis
#10
Alexandra Ahmet, Eric I Benchimol, Ellen B Goldbloom, Janice L Barkey
BACKGROUND: Adrenal suppression (AS), a glucocorticoid (GC) side effect associated with significant morbidity, is well described related to inhaled corticosteroid therapy for asthma. Swallowed topical glucocorticoid therapy is the main pharmacotherapy treatment for eosinophilic esophagitis (EoE) and therefore children with EoE are potentially at increased risk of AS. METHODS: In this prospective cohort study, we included children and youth <18 years diagnosed with EoE and treated with swallowed fluticasone or oral viscous budesonide for more than 1 month...
2016: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/27742702/trail-deficiency-and-pp2a-activation-with-salmeterol-ameliorates-egg-allergen-driven-eosinophilic-esophagitis
#11
Leon A Sokulsky, Adam M Collison, Scott Nightingale, Anna Le Fevre, Elizabeth Percival, Malcolm R Starkey, Philip M Hansbro, Paul S Foster, Joerg Mattes
Food antigens are common inflammatory triggers in pediatric eosinophilic esophagitis (EoE). TNF-related apoptosis-inducing ligand (TRAIL) promotes eosinophilic inflammation through the upregulation of the E3 ubiquitin ligase Midline (MID)-1 and subsequent downregulation of protein phosphatase 2A (PP2A), but the role of this pathway in EoE that is experimentally induced by repeated food antigen challenges has not been investigated. Esophageal mucosal biopsies were collected from children with EoE and controls and assessed for TRAIL and MID-1 protein and mRNA transcript levels...
December 1, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/27741150/eosinophilic-esophagitis-in-an-octogenarian-a-case-report-and-review-of-the-literature
#12
Anca Trifan, Oana Stoica, Catalin-Alexandru Chihaia, Mihai Danciu, Carol Stanciu, Ana-Maria Singeap
INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by a marked eosinophilic infiltrate in the esophageal mucosa. What was once considered a rare disease has nowadays become one of the most frequent esophageal diseases in the Western countries, occupying a place just next to the gastroesophageal reflux disease. EoE etiology and pathogenesis remain largely unknown, although most studies consider that allergic and genetic factors play the most important role...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27741060/elevated-serum-tissue-transglutaminase-antibodies-in-children-with-eosinophilic-esophagitis
#13
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 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 over a four-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...
October 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27727140/eosinophilic-esophagitis-demographic-clinical-endoscopic-histological-and-allergological-characteristics-in-children-and-teenagers-in-a-region-of-central-spain
#14
E Gómez Torrijos, P Sánchez Miranda, P Donado Palencia, A Castro Jimenez, J Rodriguez Sánchez, Y Mendez Díaz, L Moreno Lozano, R García Rodríguez
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic inflammatory emerging disease of the oesophagus with immunoallergic aetiology. Until now, few studies about this disease in children and adolescents have been published Objectives: To study the demographic, clinical, serologic, endoscopic-histological and allergologic characteristics of the patients and their atopic and digestive comorbidities. METHODOLOGY: It is an prospective observacional study in children and adolescents (<16 years) assessed in a multidisciplinary specialized eosinpophilic esopahgitis unit in a tertiary referral centre in the central region of Spain carried out between 2011-2015...
October 10, 2016: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/27726042/eosinophilic-esophagitis-from-an-allergy-perspective-how-to-optimally-pursue-allergy-testing-dietary-modification-in-the-adult-population
#15
Emily C McGowan, Thomas A Platts-Mills
Eosinophilic esophagitis (EoE) is a clinicopathologic condition characterized by symptoms of esophageal dysfunction and eosinophil-predominant inflammation. In adults, the three most common treatment options are swallowed steroids, elimination diets, and periodic esophageal dilations. Many different elimination diets have been studied in adults, including elemental diets, allergy testing-directed diets, and empiric elimination diets. This article will review the existing data on these dietary therapies and will propose an approach to dietary management in adult EoE...
November 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27712908/how-to-improve-the-diagnosis-of-eosinophilic-esophagitis-experience-from-a-case-series-in-mexico
#16
R Soto-Solís, K Santana-de Anda, N González-Uribe, C Gallegos, C Romo-Aguirre, J M Remes-Troche, M A Ballesteros-Amozurrutia
INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic, immune disorder mediated largely by food antigens. It shares nonspecific symptoms with gastroesophageal reflux disease (GERD). EoE is rarely reported in Mexico, perhaps due to the racial characteristics of the population or because of insufficient diagnostic suspicion. AIMS: Our aim was to describe a Mexican cohort with EoE and evaluate the usefulness of the clinical history and endoscopy in the EoE diagnosis, in comparison with GERD patients...
October 3, 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27697608/insight-into-the-role-of-tslp-in-inflammatory-bowel-diseases
#17
Jae Hyon Park, Dong Yeon Jeong, Laurent Peyrin-Biroulet, Michael Eisenhut, Jae Il Shin
Proinflammatory cytokines are thought to modulate pathogeneses of various inflammatory bowel diseases (IBDs). Thymic stromal lymphopoietin (TSLP), which has been studied in various allergic diseases such as asthma, atopic dermatitis (AD) and eosinophilic esophagitis (EoE), has been less considered to be involved in IBDs. However, mucosal dendritic cells (DCs) induced by various cytokines including TSLP were reported to cause polarization of T cell toward Th2 response, the differentiation of regulatory T-cell (Treg), and secretion of IgA by B cells...
October 1, 2016: Autoimmunity Reviews
https://www.readbyqxmd.com/read/27695356/managing-eosinophilic-esophagitis-challenges-and-solutions
#18
Nisha A Shah, Dustin M Albert, Noah M Hall, Fouad J Moawad
Eosinophilic esophagitis (EoE) is a chronic and progressive immune-mediated condition defined by symptoms of esophageal dysfunction and dense eosinophilic infiltration of the esophageal mucosa. Therapies consist of anti-eosinophilic medications and specialized diets aimed to decrease the progression of EoE and alleviate its symptoms, namely, dysphagia and food impaction. Assessing response to therapy remains challenging, as treatment end points are not well defined and currently consist of clinical, histologic, and endoscopic features...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27680593/causes-and-outcomes-of-esophageal-perforation-in-eosinophilic-esophagitis
#19
Thomas M Runge, Swathi Eluri, Cary C Cotton, Caitlin M Burk, John T Woosley, Nicholas J Shaheen, Evan S Dellon
GOALS: To characterize patients who suffer perforation in the context of eosinophilic esophagitis (EoE) and to identify predictors of perforation. BACKGROUND: Esophageal perforation is a serious complication of EoE. MATERIALS AND METHODS: We conducted a retrospective cohort study of the University of North Carolina EoE clinicopathologic database from 2001 to 2014. Subjects were included if they had an incident diagnosis of EoE and met consensus guidelines, including nonresponse to a PPI trial...
September 27, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27673711/filaggrin-and-periostin-expression-is-altered-in-eosinophilic-esophagitis-and-normalized-with-treatment
#20
Ekaterini Politi, Aspasia Angelakopoulou, Dimitra Grapsa, Maria Zande, Kalliopi Stefanaki, Ioanna Panagiotou, Eleftheria Roma, Ekaterini Syrigou
OBJECTIVES: Previous data have suggested that filaggrin (FLG) and periostin (POSTN) genes may be dysregulated in eosinophilic esophagitis (EoE). We aimed to further evaluate the expression patterns of FLG and POSTN proteins in esophageal tissue samples of patients with EoE, as compared to those of patients with gastroesophageal reflux disease (GERD) and normal controls. METHODS: A total of 61 prospectively collected cases, including 40 children with EoE and 21 children with gastroesophageal reflux disease (GERD), and a control group of 14 sex and age-matched healthy children were enrolled...
September 24, 2016: Journal of Pediatric Gastroenterology and Nutrition
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