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Eosinophilic esophagitis in children

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https://www.readbyqxmd.com/read/29700481/the-natural-course-of-eosinophilic-esophagitis-and-long-term-consequences-of-undiagnosed-disease-in-a-large-cohort
#1
Marijn J Warners, Renske A B Oude Nijhuis, Laetitia R H de Wijkerslooth, Andreas J P M Smout, Albert J Bredenoord
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic esophageal inflammation that may lead to stricture formation. This narrowing can cause major complications including food impactions. Despite increasing interest in EoE accurate data on its natural course is scarce. Therefore, we aimed to investigate the natural course of EoE and to evaluate the association between undiagnosed disease and the occurrence of complications over two decades in a large cohort. METHODS: We retrospectively analyzed charts of patients diagnosed with EoE between 1996 and 2015, collected from 15 hospitals throughout the Netherlands...
April 27, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29678750/specific-igg-4-antibodies-to-cow-s-milk-proteins-in-pediatric-eosinophilic-esophagitis
#2
Alexander J Schuyler, Jeffrey M Wilson, Anubha Tripathi, Scott P Commins, Princess U Ogbogu, Patrice G Kruzsewski, Barrett H Barnes, Emily C McGowan, Lisa J Workman, Jonas Lidholm, Sheryl L Rifas-Shiman, Emily Oken, Diane R Gold, Thomas A E Platts-Mills, Elizabeth A Erwin
BACKGROUND: Allergen-specific IgG4 antibodies are often associated with tolerance, but specific IgG4 antibodies (sIgG4 ) to causally relevant foods have recently been reported in adult eosinophilic esophagitis (EoE). Prevalence and levels of food-sIgG4 are not well established in the general pediatric population. OBJECTIVE: We sought to investigate serum food-sIgG4 with component diagnostics in children with EoE and children from an unselected birth cohort and to explore the effects of sex, age and milk consumption on sIgG4 levels METHODS: Sera from 71 cases of pediatric EoE and 210 early-adolescent children from an unselected birth cohort (Project Viva) were assayed for sIgG4 and specific IgE (sIgE) to major cow's milk (CM) proteins (α-lactalbumin, β-lactoglobulin, caseins) and to wheat, soy, egg, and peanut proteins...
April 17, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29617744/natural-history-of-eosinophilic-esophagitis-a-systematic-review-of-epidemiology-and-disease-course
#3
N J Shaheen, V Mukkada, C S Eichinger, H Schofield, L Todorova, G W Falk
Eosinophilic esophagitis is a chronic immune-mediated esophageal disorder. For its timely diagnosis, clinicians must recognize common symptoms, and understand differences in symptoms across patient groups. The aim of this study is to systematically review the epidemiology and natural history of eosinophilic esophagitis. The MEDLINE, Embase, and Cochrane databases were searched from 1974 to February 2017 for studies describing the epidemiology and natural history of eosinophilic esophagitis. Congress abstracts from 2014 to 2016 were also searched...
March 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29614304/decreased-esophageal-distensibility-in-children-with-eosinophilic-esophagitis-is-fibrosis-inevitable
#4
Jennifer L Horsley-Silva, Evan S Dellon
No abstract text is available yet for this article.
April 1, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29571547/eosinophilic-esophagitis
#5
Amanda B Muir
Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease of the esophagus that effects children and adults. Typical symptoms of EoE typically involve failure to thrive and vomiting in small children, and dysphagia and food impaction in adolescents and adults. However, throat clearing, choking, gagging, and hoarseness have also been observed and these issues often bring patients to first seek otolaryngology and pulmonary evaluation. Diagnosis is only made by esophogastroduodenoscopy with biopsy, so clinicians must have a low threshold for considering eosinophilic esophagitis even in the absence of frank gastrointestinal symptoms...
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29549437/treatment-of-eosinophilic-esophagitis-in-the-pediatric-patient-an-evidence-based-approach
#6
REVIEW
Mery Munoz-Persy, Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a unique form of non-IgE-mediated food allergy characterized by esophageal eosinophilic infiltration that commonly causes dysphagia and food impaction in children and adolescents. Assessing the efficacy of dietary restrictions or drug therapies to achieve clinical and histologic resolution of EoE through randomized controlled trials and meta-analyses has resulted in new evidence-based guidelines. Avoiding food triggers is the only therapy targeting the cause of the disease...
March 17, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29545632/helicobacter-pylori-infection-does-not-protect-against-eosinophilic-esophagitis-results-from-a-large-multicenter-case-control-study
#7
Javier Molina-Infante, Carolina Gutierrez-Junquera, Edoardo Savarino, Roberto Penagini, Ines Modolell, Ottavia Bartolo, Alicia Prieto-García, Aurelio Mauro, Javier Alcedo, Antonia Perelló, Carlos Guarner-Argente, Noelia Alcaide, Ana M Vegas, Patricia Barros-García, Marianette Murzi-Pulgar, Monica Perona, Javier P Gisbert, Alfredo J Lucendo
OBJECTIVES: Rising trends in eosinophilic esophagitis (EoE) have been repeatedly linked to declining Helicobacter pylori (H. pylori) infection, mostly in retrospective studies. We aimed to prospectively evaluate this inverse association. METHODS: Prospective case-control study conducted in 23 centers. Children and adults naïve to eradication therapy for H. pylori were included. Cases were EoE patients, whereas controls were defined by esophageal symptoms and <5 eos/HPF on esophageal biopsies...
March 15, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29543695/mucosal-impedance-measurements-differentiate-pediatric-patients-with-active-vs-inactive-eosinophilic-esophagitis
#8
Mary Allyson Lowry, Michael F Vaezi, Hernan Correa, Tina Higginbotham, James C Slaughter, Sari Acra
BACKGROUND & AIMS: Eosinophilic esophagitis (EoE) is a chronic disorder in children that requires continued assessment of disease activity, involving repeated sedation, endoscopy, and biopsy analysis. We investigated whether mucosal impedance measurements can be used to monitor disease activity in pediatric patients with EoE. METHODS: We measured mucosal impedance at 3 locations in the esophagus in pediatric patients (1-18 years old; 32 with active EoE, 10 with inactive EoE, 32 with non-erosive reflux disease [NERD]) and 53 children with symptoms but normal findings from histologic analyses (controls) undergoing routine esophagogastroduodenoscopy at the Vanderbilt Pediatric Gastroenterology Clinic...
March 14, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29522850/dietary-therapy-for-eosinophilic-esophagitis
#9
Javier Molina-Infante, Alfredo J Lucendo
Eosinophilic esophagitis is a chronic, immune-mediated esophageal disease triggered predominantly, but not exclusively, by food antigens. Presently, available food allergy tests are suboptimal to predict food triggers for eosinophilic esophagitis, especially in adults. Elemental diets (exclusive feeding with amino acid-based formulas) and empiric 6-food elimination diets (withdrawing milk, wheat, egg, soy, nuts, and fish/seafood for 6 weeks) have consistently shown the best efficacy rates. However, their high level of restriction and need for multiple endoscopies have hampered their implementation in clinical practice...
March 6, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29511165/food-allergen-triggers-are-increased-in-children-with-the-tslp-risk-allele-and-eosinophilic-esophagitis
#10
Lisa M Fahey, Prasanna M Chandramouleeswaran, Shaobo Guan, Alain J Benitez, Glenn T Furuta, Seema S Aceves, Mei-Lun Wang, Chris A Liacouras, Amanda B Muir, Patrick Ma Sleiman, Hakon Hakonarson, Jonathan M Spergel, Antonella Cianferoni
OBJECTIVES: TSLP has been shown to be associated with eosinophilic esophagitis (EoE). Specifically, children with EoE often have the nucleotides AA or AG instead of GG at the single nucleotide polymorphism position RS3806932. Presently, the phenotypic characteristics in EoE children with the TSLP EoE risk allele are unknown. METHODS: A retrospective analysis was performed of all children with EoE who had TSLP genotyping at The Children's Hospital of Philadelphia from 2008-2014...
March 6, 2018: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/29509636/long-term-treatment-with-proton-pump-inhibitors-is-effective-in-children-with-eosinophilic-esophagitis
#11
Carolina Gutiérrez-Junquera, Sonia Fernández-Fernández, M Luz Cilleruelo, Ana Rayo, Luis Echeverría, Belén Borrell, Enriqueta Román
OBJECTIVES: Proton pump inhibitor (PPI)-responsive eosinophilic esophagitis (EoE) is frequently observed in children, but data on long-term treatment are scarce. The objective of this study is to evaluate the long-term efficacy and safety of PPIs in children with EoE. METHODS: This prospective study enrolled children with EoE and histological remission to an 8-week esomeprazole trial (1 mg/kg/dose, twice daily). Esomeprazole was maintained at 1 mg/kg/day for 1 year...
March 5, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29492720/eosinophilic-esophagitis-in-children-endoscopic-findings-at-diagnosis-and-post-intervention
#12
REVIEW
S M Bolton, A F Kagalwalla, J B Wechsler
PURPOSE OF REVIEW: The goal of this review is to present and summarize studies on endoscopic findings in eosinophilic esophagitis (EoE), at diagnosis and in response to treatment, utilizing rigorous peer-reviewed literature in children wherever possible and to introduce a recently proposed standardized endoscopic evaluation system. RECENT FINDINGS: Gold standard of diagnosis and assessment of response to therapy in EoE requires multiple endoscopies with biopsies for histology, which allows for observation of the esophageal mucosa...
February 28, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29455359/eosinophilic-esophagitis-an-important-comorbid-condition-of-asthma
#13
REVIEW
Sandy R Durrani, Vincent A Mukkada, Theresa W Guilbert
Eosinophilic esophagitis and asthma are frequently found as comorbid conditions in children and adults along with other manifestations of atopic diathesis. These two conditions have similar T helper 2 responses-driven pathophysiology and share common management strategies such as using systemic corticosteroids and targeted anti-cytokine biologic therapies. Review of the literature finds that asthma is often a comorbid condition in eosinophilic esophagitis in both children and adults; however, the EoE-asthma relationship remains poorly characterized mechanistically and clinically...
February 18, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29394215/practice-differences-in-the-diagnosis-and-management-of-eosinophilic-esophagitis-among-adult-and-pediatric-gastroenterologists-in-israel
#14
Eyal Zifman, Hagar Banai, Raanan Shamir, Tamar Ringel-Kulka, Noam Zevit
OBJECTIVES: Eosinophilic esophagitis (EoE) guidelines call for similar practices in adults and children with EoE. We compared the diagnostic and management practices of gastroenterologists treating adult and pediatric patients suspected of having, or diagnosed with, EoE. METHODS: A 19 question multiple choice questionnaire was given to gastroenterologists treating either adults or children. Questions explored four areas of interest: Physician demographics, diagnosis and tissue sampling practices, management, and the need for societal publications on EoE...
February 1, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29381255/airborne-and-food-sensitization-patterns-in-children-and-adults-with-eosinophilic-esophagitis
#15
Yu Ting He, Paul J Christos, William R Reisacher
BACKGROUND: The pathogenesis of eosinophilic esophagitis (EoE) is currently unknown, but evidence suggests that allergic sensitization to food and airborne allergens may play a key role. This retrospective study examines the rate of sensitization to both food and airborne allergens in EoE patients, and compares their sensitivity patterns to control groups. METHODS: We identified 103 patients with a diagnosis of EoE via esophageal eosinophilia (≥15 eosinophils/high-power field [hpf]), who had undergone comprehensive food and/or airborne allergen testing through either skin or in vitro methods...
May 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29372536/biological-therapies-for-eosinophilic-esophagitis-where-do-we-stand
#16
REVIEW
Emily Ko, Mirna Chehade
Eosinophilic esophagitis (EoE) is an immune-mediated, chronic esophageal disease characterized by esophageal symptoms and esophageal eosinophilia. It is triggered by foods and possibly by environmental allergens. Currently, there are no FDA-approved therapies for EoE. Commonly used treatments include dietary restrictions and topical corticosteroids. Many of these therapies are suboptimal in their efficacy, have side effects, or diminish patients' quality of life. Biologic therapies for EoE have therefore been sought as an alternative...
January 25, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29349695/efficacy-of-atopy-patch-testing-in-directed-dietary-therapy-of-eosinophilic-esophagitis-a-pilot-study
#17
Jason D Eckmann, Karthik Ravi, David A Katzka, Dawn R Davis, Jacalyn A See, Debra R Geno, Lori A Kryzer, Jeffrey A Alexander
BACKGROUND: Atopy patch testing (APT) has shown potential for predicting dietary food triggers in studies of children and adolescents with eosinophilic esophagitis (EoE). AIMS: To assess the efficacy of APT in adults with EoE. METHODS: We conducted a prospective open-label pilot study of patients ≥ 18 years old with diagnosis of EoE at Mayo Clinic in Rochester, Minnesota, from November 2014 to January 2016. All patients underwent patch testing using intact food products, followed by a six food elimination diet and stepwise food reintroduction...
March 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29289462/elevated-expression-of-activated-t-h-2-cells-and-milk-specific-t-h-2-cells-in-milk-induced-eosinophilic-esophagitis
#18
Antonella Cianferoni, Melanie A Ruffner, Ryan Guzek, Shaobo Guan, Terri Brown-Whitehorn, Amanda Muir, Jonathan M Spergel
BACKGROUND: Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Esophageal biopsy specimens are characterized by eosinophilia and expression of TH 2 cytokines. OBJECTIVE: To ascertain whether TH 2 cells can exist in the peripheral blood in patients with milk-induced EoE. METHODS: Peripheral blood mononuclear cells from 20 children with milk-induced EoE were collected during active EoE (EoE-A) while consuming milk and inactive EoE (EoE-I) while not consuming milk, and 8 healthy patients without EoE were used as controls...
February 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29248734/eosinophilic-esophagitis-reference-score-accurately-identifies-disease-activity-and-treatment-effects-in-children
#19
Josh B Wechsler, S Bolton, K Amsden, B K Wershil, I Hirano, Amir F Kagalwalla
BACKGROUND & AIMS: The endoscopic reference score (EREFS) is used to determine severity of 5 endoscopic findings: edema, rings, exudates, furrows, and strictures. Little is known about the relationship between EREFSs and histologic markers of disease activity in children with eosinophilic esophagitis (EoE). We aimed to determine whether the EREFS can be used to identify children with EoE and how it changes with treatment. METHODS: We performed a prospective study of consecutive children (ages 2-17 years) undergoing diagnostic or post-treatment endoscopy scored real-time with EREFS from December 2012 through 2016...
December 15, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29234969/monoclonal-antibodies-for-treatment-of-eosinophilic-esophagitis
#20
REVIEW
Mahsa Eskian, MirHojjat Khorasanizadeh, Amal H Assa'ad, Nima Rezaei
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus affecting both children and adults, with debilitating and progressive symptoms. EoE has shown an explosive epidemiological rise in the past few decades. Many patients experience a poor level of disease control despite maximal use of available guideline-based therapies, which seriously hampers their quality of life. Diet restrictions and systemic and topical corticosteroids are the current mainstays of EoE therapy, but are associated with significant efficacy, treatment compliance, and safety issues such as oral or esophageal candidiasis, growth retardation, osteopenia, osteoporosis, glucose intolerance, and cataract formation...
December 12, 2017: Clinical Reviews in Allergy & Immunology
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