Eosinophilic esophagitis

Gastroenterol Clin North Am. 2013 Mar;42(1):133-53. doi: 10.1016/j.gtc.2012.11.008. Epub 2012 Dec 27.

Abstract

Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition whereby infiltration of eosinophils into the esophageal mucosa leads to symptoms of esophageal dysfunction. EoE is encountered in a substantial proportion of patients undergoing diagnostic upper endoscopy. This review discusses the clinical, endoscopic, and histologic features of EoE and presents the most recent guidelines for its diagnosis. Selected diagnostic dilemmas are described, including distinguishing EoE from gastroesophageal reflux disease and addressing the newly recognized clinical entity of proton-pump inhibitor-responsive esophageal eosinophilia. Also highlighted is evidence to support both pharmacologic and nonpharmacologic treatments, including topical corticosteroids, dietary elimination therapy, and endoscopic dilation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Topical
  • Adrenal Cortex Hormones / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Diet Therapy
  • Dilatation
  • Eosinophilic Esophagitis / diagnosis
  • Eosinophilic Esophagitis / pathology
  • Eosinophilic Esophagitis / therapy*
  • Esophagoscopy
  • Humans
  • Immunologic Factors / therapeutic use
  • Interleukin-5 / antagonists & inhibitors

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal, Humanized
  • Immunologic Factors
  • Interleukin-5
  • reslizumab
  • mepolizumab