Document Detail


Eosinophilic esophagitis: asthma of the esophagus?
MedLine Citation:
PMID:  15224275     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Eosinophilic esophagitis (EE) is rapidly emerging as a distinct disease entity in both pediatric and adult gastroenterology. The typical clinical presentation includes solid food dysphagia in young men who have an atopic predisposition. Food impaction necessitating endoscopic intervention is common. EE should be suspected, in particular, in patients with unexplained dysphagia or those with no response to antacid or anti-acid secretory therapy. Careful endoscopic and radiographic examinations reveal furrows, corrugations, rings, whitish plaques, fragile crêpe paper-like appearance, and a small-caliber esophagus. Mucosal erosion in the distal esophagus, characteristic to reflux esophagitis, is absent in EE. Marked eosinophil infiltration in the esophageal epithelia (>20 eosinophils per high-power field) is the diagnostic hallmark. Food antigens and aeroallergens may play a role in the pathogenesis of EE. The mechanisms may be dependent or independent of immunoglobulin E. Elimination diets, systemic and topical corticosteroids, leukotriene receptor antagonists, and, most recently, an anti-interleukin-5 monoclonal antibody have been used to treat EE. EE likely represents another example of eosinophil-associated inflammation of epithelia at the interface between external and internal milieu, similar to bronchial asthma and atopic dermatitis. This review summarizes recent progress in the diagnosis and management of EE and discusses future research directions.
Authors:
Amindra S Arora; Kiyoshi Yamazaki
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  2     ISSN:  1542-3565     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-29     Completed Date:  2004-09-22     Revised Date:  2006-09-18    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  523-30     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Distribution
Asthma / diagnosis*,  epidemiology
Biopsy, Needle
Child
Child, Preschool
Combined Modality Therapy
Diagnosis, Differential
Diet
Eosinophilia / diagnosis*,  epidemiology,  therapy
Esophagitis / diagnosis*,  epidemiology,  therapy
Esophagoscopy / methods
Female
Humans
Immunohistochemistry
Male
Prevalence
Prognosis
Severity of Illness Index
Sex Distribution
Steroids / therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Steroids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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