Review article
https://doi.org/10.26800/LV-144-supl1-16
Eosinophilic esophagitis – what have we learned so far?
Orjena Žaja
; Klinika za pedijatriju, Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska, Stomatološki fakultet Sveučilišta u Zagrebu, Medicinski fakultet Sveučilišta u Splitu
Vedrana Čović
; Medicinski fakultet Sveučilišta u Splitu
Matea Crnković Ćuk
; Klinika za pedijatriju, Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska
Barbara Perše
; Klinika za pedijatriju, Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska
Abstract
Eosinophilic esophagitis (EoE) is currently defined as a chronic, immune-mediated progressive disease of the oesophagus, characterized by eosinophilic infiltration and symptoms of oesophageal dysfunction. Food-based allergens have a dominant role in mediating the immune response. It is a new entity, first described in the literature at the end of the last century. The scientists confirmed that EoE is a new phenomenon and not a better recognition due to new diagnostic methods. Following the atopy epidemiological trends in general, there is a significant increase in EoE incidence. Patients often have a personal or family history of atopic disorders, such as asthma, eczema, rhinitis, and food anaphylaxis. EoE can occur at any age, with different age-dependent clinical manifestations. Untreated disease leads to permanent damage of the esophageal function, connective tissue
transformation with consequent stenosis. The diagnostic and therapeutic approach has undergone numerous and significant changes, but the basis for confirming EoE remain histological analysis of the oesophageal mucosa. Still, there is no valid biomarker that could replace oesophageal biopsy and thus allow non-invasive methods to monitor patients. Therefore, one of the biggest challenges in the treatment of children and adolescents is the large
number of endoscopies necessary to monitor disease activity. Various treatment options have been used in paediatric patients, including proton pump inhibitors, elimination diets, ingested topical steroids, and endoscopic dilatations. More recently, oesophageal eosinophilia that responds to a proton pump inhibitor and EoE have been considered as part of the same spectrum, and proton pump inhibitors are considered the first line in the treatment.
Despite dramatic advances in understanding the pathogenesis and evolution of disease in the relatively short period of time since the discovery and first description of EoE three decades ago, many open questions remain unresolved.
Keywords
EOSINOPHILIC ESOPHAGITIS; ESOPHAGEAL EOSINOPHILIA; PROTON PUMP INHIBITORS; CLINICAL MANIFESTATION; FOOD ALLERGY
Hrčak ID:
275720
URI
Publication date:
24.4.2022.
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