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Diagnosis and Treatment of Eosinophilic Esophagitis


Straumann, Alex; Katzka, David A (2018). Diagnosis and Treatment of Eosinophilic Esophagitis. Gastroenterology, 154(2):346-359.

Abstract

Eosinophilic esophagitis (EoE) is a new disease. It is caused by a T-helper 2 cell response to food antigens in contact with the esophageal mucosa. Although no single feature defines EoE, a constellation of compatible demographic, clinical, endoscopic, and histologic findings establish the diagnosis. Children present with symptoms and endoscopic patterns characteristic of inflammation, whereas adolescents and adults have manifestations of fibrosis and gross esophageal strictures. Clinical and endoscopic scoring systems have helped to standardize diagnosis. There is controversy in EoE research over the optimal endpoint for treatment. Although the most common endpoint is a reduced number of eosinophils in biopsies, changes in symptoms and endoscopic features are becoming important targets of therapy. We should improve our understanding of EoE progression and the need for maintenance therapy, and continue development of diagnostic tools that avoid endoscopy and biopsy analyses, to more easily monitor disease activity.

Abstract

Eosinophilic esophagitis (EoE) is a new disease. It is caused by a T-helper 2 cell response to food antigens in contact with the esophageal mucosa. Although no single feature defines EoE, a constellation of compatible demographic, clinical, endoscopic, and histologic findings establish the diagnosis. Children present with symptoms and endoscopic patterns characteristic of inflammation, whereas adolescents and adults have manifestations of fibrosis and gross esophageal strictures. Clinical and endoscopic scoring systems have helped to standardize diagnosis. There is controversy in EoE research over the optimal endpoint for treatment. Although the most common endpoint is a reduced number of eosinophils in biopsies, changes in symptoms and endoscopic features are becoming important targets of therapy. We should improve our understanding of EoE progression and the need for maintenance therapy, and continue development of diagnostic tools that avoid endoscopy and biopsy analyses, to more easily monitor disease activity.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gastroenterology and Hepatology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2018
Deposited On:16 Jan 2018 14:00
Last Modified:20 Feb 2018 09:01
Publisher:Elsevier
ISSN:0016-5085
OA Status:Closed
Publisher DOI:https://doi.org/10.1053/j.gastro.2017.05.066
PubMed ID:28756235

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