[Eosinophilic esophagitis--from a rare pediatric disease to the forefront of adult gastroenterology].
Eosinophilic esophagitis (EE) is a disease whose presence has exploded in clinical practice. Because of its relative novelty, the epidemiology, pathogenesis, clinical manifestations, diagnosis and treatment of EE are constantly evolving. EE was first recognized as a disease predominantly of children, but the publications in the last few years describe it like an adult disease, too. It is not known if its frequency is truly increasing in an antigen underexposed society or the disease was previously not recognized. The diagnosis requires the histologic finding of more than 20 eosinophils per high powered field in esophageal squamous mucosa. The specific antigens that initiate EE are unknown, but both food and aeroallergens are involved. The mechanisms by which EE induces esophageal dis-motility, chronic inflammation with fibrosis, and stricture formation are still unclear. The mucosa of the patients affected by EE contains increased numbers of CD8 lymphocytes, tumor necrosis factor alpha, I1-5 and eotaxin. The main symptoms in adult are: dysphagia and food impaction. Endoscopy commonly reveals strictures, mucosal rings, linear furrowing, corrugation, and white plaques. The common treatment regimens in children and adults involve the ingestion of topical corticosteroids.
Mihai
Cătălina
C
Institutul de Gastroenterologie si Hepatologie, Facultatea de Medicină, Universitatea de Medicină si Farmacie "Gr.T. Popa", Iaşi.
Prelipcean
Cristina Cijevschi
CC
Gogălniceanu
P
P
Drug
V L
VL
Stanciu
C
C
D000328:Adult; D000730:Androstadienes / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D003680:Deglutition Disorders / Q000209:etiology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy; D004941:Esophagitis / Q000175:diagnosis* / Q000188:drug therapy; D000068298:Fluticasone; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use; D035583:Rare Diseases; D016896:Treatment Outcome
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D000068298:Fluticasone; D011241:Prednisone