Eosinophilic Gastrointestinal Diseases in Children: A Practical Review (original) (raw)
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High Prevalence of Eosinophilic Gastrointestinal Disease in Children With Intestinal Failure
Journal of Pediatric Gastroenterology & Nutrition, 2016
Objectives: The aim of the present study was to describe the prevalence and clinical features of gastrointestinal (GI) eosinophilic inflammation among pediatric patients with intestinal failure (IF). Methods: Medical records of all patients studied in our institution's IF program who underwent GI endoscopy over a 15-year period were reviewed, and clinical, pathologic, nutrition, and laboratory data collected. Results: One hundred five patients underwent 208 GI endoscopic procedures with biopsy. The overall prevalence of eosinophilic inflammation, defined as increased eosinophils in at least 1 tissue type on at least 1 endoscopy, was 39 of 105 (37%). The tissue-specific prevalence of eosinophilic inflammation ranged widely, with the colon/rectosigmoid being the most common (18/68, 26%), followed by the esophagus (17/83, 20%), ileum (9/54, 17%), duodenum (4/83, 5%), and stomach (3/83, 4%). Higher peripheral eosinophil count and hematochezia were associated with eosinophilic inflam...
Clinical Implications of Pediatric Colonic Eosinophilia
Journal of pediatric gastroenterology and nutrition, 2017
Pediatric colonic eosinophilia represents a confounding finding with a wide differential. It is often difficult to determine which children may progress to inflammatory bowel disease (IBD), which have an eosinophilic colitis (EC), and which may have no underlying pathology. There is little guidance for the practitioner on the approach to these patients. To define the clinical presentations of colonic eosinophilia and identify factors which may aid in diagnosis we reviewed patients with colonic eosinophilia and the clinicopathologic factors associated with their diagnoses. An 8-year retrospective chart review of children whose histopathology identified colonic eosinophilia (N = 72) compared to controls with normal biopsies (N = 35). Patients with colonic eosinophilia had increased eosinophils/high power field (eos/HPF) compared to controls (p < 0.001) and had three clinical phenotypes. Thirty six percent had an inflammatory phenotype with elevated ESR (p < .0001), chronic infla...
2012- Seminars-Eosinophilic gastrointestinal disease
2013
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Eosinophilic esophagitis: What can we learn from Crohns disease?
United European Gastroenterology Journal, 2016
Eosinophilic esophagitis (EoE) is an emerging esophageal inflammatory disorder affecting children and young adults. As a relatively new disease, EoE is still burdened by frequent diagnostic and therapeutic pitfalls in clinical practice. This manuscript posits a number of similarities with Crohn's disease, which may help optimize EoE patient management. Commonalities include epidemiologic trends (Westernized diseases, rising incidence, early-life risk factors), diagnostic considerations (symptoms are poor predictors of disease activity, difficulties in disease activity assessment) and therapeutic issues (similar natural history and therapeutic goals, induction and maintenance phases, combination of drug and endoscopic treatment, potential drug interchangeability, long-term unsolved issues). Physicians devoted to EoE should learn from the extraordinary achievements fulfilled in Crohn's disease: increased disease awareness, multidisciplinary specialized clinics, structured childhood and transition programs, and an ongoing roadmap for personalized treatments, including genetic susceptibility, risk factors for progression, genotype-phenotype correlation, drug monitoring and microbial data.
Idiopathic eosinophilic gastrointestinal diseases in adults
Best Practice & Research Clinical Gastroenterology, 2008
This review focuses on the latest cognitions, diagnosis and treatment strategies of the three main representatives of the eosinophilic gastrointestinal disorders (EGID): idiopathic eosinophilic oesophagitis (EE), idiopathic eosinophilic gastroenteritis (EGE) and idiopathic hypereosinophilic syndromes (HES) with gastrointestinal involvement. These disorders share important similarities: their origin is unknown and their pathogenesis is due to a histological inflammatory response characterised by eosinophilic tissue infiltration.
2013
Eosinophilic gastrointestinal disorders constitute a pathology characterized by eosinophilic infiltration of the gastrointestinal tract, the symptoms of which vary depending on the affected digestive segments and the involvement of the different layers of the digestive wall. Eosinophilic gastrointestinal diseases include subcategories such as eosinophilic esophagitis, eosinophilic gastroenteritis and eosinophilic colitis, and depending on the localization of the eosinophilia, it is possible to group them as mucosal, serosal or muscular disease. Mucosal involvement is the most common. Patients with eosinophilic esophagitis suffer from nutrition intolerance, vomiting, and dysphagia; for patients with eosinophilic gastroenteritis, complaints are abdominal pain, diarrhea and blood in stool; and for patients with eosinophilic colitis, they are typically diarrhea and lower quadrant pain. The disease is typically observed in but not limited to the 3rd to 5th decades. The main therapeutic o...