title: Eosinophilic esophagitis in children.
abstract: Eosinophilic esophagitis (EoE) is a relatively common chronic immune-mediated disease of the esophagus characterized clinically by symptoms of esophageal dysfunction that vary by age. Histologically, EoE results in marked esophageal eosinophilia despite treatment with high-dose proton pump inhibition. The cornerstone of treatment is dietary restriction and/or pharmacologic therapy, mainly with topical steroids. This review briefly describes dietary therapy, but focuses on the various medical options in the treatment of EoE, with an emphasis on steroid-based therapy. Numerous landmark studies are reviewed describing the symptomatic and histologic endpoints as well as safety data. The literature strongly supports the use of topical steroid therapy as a means of significantly decreasing eosinophilic mucosal disease. Specifically, high-dose fluticasone propionate appears to be very effective, and has been shown to result in the resolution of mucosal eosinophilia in a large percentage of treated patients. Long-term studies over many years will need to determine whether mucosal healing will change the natural history of this stricture-causing disease. In addition to topical therapy, various other drug-based therapies are reported, including newer immune-based monoclonal antibodies.
authors: The Unterberg Children's Hospital at Monmouth Medical Center, Long Branch, NJ, USA.
authors: Prerna
authors: P
authors: Trivedy
authors: Jonathan E
authors: JE
authors: Teitelbaum
mesh_terms: D000818:Animals; D002648:Child; D057765:Eosinophilic Esophagitis / Q000178:diet therapy / Q000188:drug therapy*; D000068298:Fluticasone / Q000627:therapeutic use*; D006801:Humans; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
chemical_list: D054328:Proton Pump Inhibitors; D000068298:Fluticasone