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Erschienen in: Clinical Reviews in Allergy & Immunology 1/2018

30.12.2017

Eosinophilic Esophagitis Clinical Manifestations and Differential Diagnosis

verfasst von: Diana Muñoz-Mendoza, Adrián Chapa-Rodríguez, Sami L. Bahna

Erschienen in: Clinical Reviews in Allergy & Immunology | Ausgabe 1/2018

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Abstract

As a chronic inflammatory disease with eosinophilic infiltrate of the esophagus, eosinophilic esophagitis (EoE) causes a variety of gastrointestinal (GI) clinical manifestations. None of the symptoms, endoscopic features, or biopsy findings is pathognomonic of the disease, even with high degrees of esophageal eosinophilia. The pathogenesis has been explored by several studies, yet it still far from being completely understood. Evidence supports a role of allergen-driven Th2 lymphocyte mechanism, though not in every patient. This article addresses the disease’s clinical manifestations, endoscopic findings, diagnosis, and differential diagnoses. In addition to the current diagnostic criteria, we summarize some recently emerging procedures that promise of enhancing more precise diagnosis and institution of early appropriate management, with consequent better quality of life and reduction of complications.
Literatur
1.
Zurück zum Zitat Dobbins JW, Sheahan DG, Behar J (1977) Eosinophilic gastroenteritis with esophageal involvement. Gastroenterology 72(6):1312–1316PubMed Dobbins JW, Sheahan DG, Behar J (1977) Eosinophilic gastroenteritis with esophageal involvement. Gastroenterology 72(6):1312–1316PubMed
2.
Zurück zum Zitat Furuta GT, Liacouras CA, Collins MH, Gupta SK, Justinich C, Putnam PE, Bonis P, Hassall E, Straumann A, Rothenberg ME, First International Gastrointestinal Eosinophil Research Symposium (FIGERS) Subcommittees (2007) Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology 133(4):1342–1363. https://doi.org/10.1053/j.gastro.2007.08.017 PubMedCrossRef Furuta GT, Liacouras CA, Collins MH, Gupta SK, Justinich C, Putnam PE, Bonis P, Hassall E, Straumann A, Rothenberg ME, First International Gastrointestinal Eosinophil Research Symposium (FIGERS) Subcommittees (2007) Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology 133(4):1342–1363. https://​doi.​org/​10.​1053/​j.​gastro.​2007.​08.​017 PubMedCrossRef
15.
Zurück zum Zitat Giriens B, Yan P, Safroneeva E, Zwahlen M, Reinhard A, Nydegger A, Vavricka S, Sempoux C, Straumann A, Schoepfer AM (2015) Escalating incidence of eosinophilic esophagitis in Canton of Vaud, Switzerland, 1993–2013: a population-based study. Allergy 70(12):1633–1639. https://doi.org/10.1111/all.12733 PubMedCrossRef Giriens B, Yan P, Safroneeva E, Zwahlen M, Reinhard A, Nydegger A, Vavricka S, Sempoux C, Straumann A, Schoepfer AM (2015) Escalating incidence of eosinophilic esophagitis in Canton of Vaud, Switzerland, 1993–2013: a population-based study. Allergy 70(12):1633–1639. https://​doi.​org/​10.​1111/​all.​12733 PubMedCrossRef
20.
Zurück zum Zitat Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, Burks AW, Chehade M, Collins MH, Dellon ES, Dohil R, Falk GW, Gonsalves N, Gupta SK, Katzka DA, Lucendo AJ, Markowitz JE, Noel RJ, Odze RD, Putnam PE, Richter JE, Romero Y, Ruchelli E, Sampson HA, Schoepfer A, Shaheen NJ, Sicherer SH, Spechler S, Spergel JM, Straumann A, Wershil BK, Rothenberg ME, Aceves SS (2011) Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol 128(1):3–20.e6; quiz 21-2. https://doi.org/10.1016/j.jaci.2011.02.040 PubMedCrossRef Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, Burks AW, Chehade M, Collins MH, Dellon ES, Dohil R, Falk GW, Gonsalves N, Gupta SK, Katzka DA, Lucendo AJ, Markowitz JE, Noel RJ, Odze RD, Putnam PE, Richter JE, Romero Y, Ruchelli E, Sampson HA, Schoepfer A, Shaheen NJ, Sicherer SH, Spechler S, Spergel JM, Straumann A, Wershil BK, Rothenberg ME, Aceves SS (2011) Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol 128(1):3–20.e6; quiz 21-2. https://​doi.​org/​10.​1016/​j.​jaci.​2011.​02.​040 PubMedCrossRef
27.
Zurück zum Zitat van Rhijn BD, van Ree R, Versteeg SA, Vlieg-Boerstra BJ, Sprikkelman AB, Terreehorst I, Smout AJPM, Bredenoord AJ (2013) Birch pollen sensitization with cross-reactivity to food allergens predominates in adults with eosinophilic esophagitis. Allergy 68(11):1475–1481. https://doi.org/10.1111/all.12257 PubMedCrossRef van Rhijn BD, van Ree R, Versteeg SA, Vlieg-Boerstra BJ, Sprikkelman AB, Terreehorst I, Smout AJPM, Bredenoord AJ (2013) Birch pollen sensitization with cross-reactivity to food allergens predominates in adults with eosinophilic esophagitis. Allergy 68(11):1475–1481. https://​doi.​org/​10.​1111/​all.​12257 PubMedCrossRef
36.
Zurück zum Zitat Wolf WA, Piazza NA, Gebhart JH, Rusin S, Covey S, Higgins LL, Beitia RM, Speck O, Woodward K, Cotton CC, Runge TM, Eluri S, Woosley JT, Shaheen NJ, Dellon ES (2017) Association between body mass index and clinical and endoscopic features of eosinophilic esophagitis. Dig Dis Sci 62(1):143–149. https://doi.org/10.1007/s10620-016-4357-1 PubMedCrossRef Wolf WA, Piazza NA, Gebhart JH, Rusin S, Covey S, Higgins LL, Beitia RM, Speck O, Woodward K, Cotton CC, Runge TM, Eluri S, Woosley JT, Shaheen NJ, Dellon ES (2017) Association between body mass index and clinical and endoscopic features of eosinophilic esophagitis. Dig Dis Sci 62(1):143–149. https://​doi.​org/​10.​1007/​s10620-016-4357-1 PubMedCrossRef
43.
Zurück zum Zitat Jackson WE, Mehendiratta V, Palazzo J, Dimarino AJ, Quirk DM, Cohen S (2013) Boerhaave’s syndrome as an initial presentation of eosinophilic esophagitis: a case series. Ann Gastroenterol 26(2):166–169PubMedPubMedCentral Jackson WE, Mehendiratta V, Palazzo J, Dimarino AJ, Quirk DM, Cohen S (2013) Boerhaave’s syndrome as an initial presentation of eosinophilic esophagitis: a case series. Ann Gastroenterol 26(2):166–169PubMedPubMedCentral
44.
Zurück zum Zitat Vernon N, Mohananey D, Ghetmiri E, Ghaffari G (2014) Esophageal rupture as a primary manifestation in eosinophilic esophagitis. Case Rep Med 2014:673189PubMedPubMedCentralCrossRef Vernon N, Mohananey D, Ghetmiri E, Ghaffari G (2014) Esophageal rupture as a primary manifestation in eosinophilic esophagitis. Case Rep Med 2014:673189PubMedPubMedCentralCrossRef
50.
52.
Zurück zum Zitat Dellon ES, Gonsalves N, Hirano I, Furuta GT, Liacouras CA, Katzka DA, American College of Gastroenterology (2013) ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol 108(5):679–692; quiz 693. https://doi.org/10.1038/ajg.2013.71 PubMedCrossRef Dellon ES, Gonsalves N, Hirano I, Furuta GT, Liacouras CA, Katzka DA, American College of Gastroenterology (2013) ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol 108(5):679–692; quiz 693. https://​doi.​org/​10.​1038/​ajg.​2013.​71 PubMedCrossRef
53.
Zurück zum Zitat Papadopoulou A, Koletzko S, Heuschkel R, Dias JA, Allen KJ, Murch SH, Chong S, Gottrand F, Husby S, Lionetti P, Mearin ML, Ruemmele FM, Schäppi MG, Staiano A, Wilschanski M, Vandenplas Y, ESPGHAN Eosinophilic Esophagitis Working Group and the Gastroenterology Committee (2014) Management guidelines of eosinophilic esophagitis in childhood. J Pediatr Gastroenterol Nutr 58(1):107–118. https://doi.org/10.1097/MPG.0b013e3182a80be1 PubMedCrossRef Papadopoulou A, Koletzko S, Heuschkel R, Dias JA, Allen KJ, Murch SH, Chong S, Gottrand F, Husby S, Lionetti P, Mearin ML, Ruemmele FM, Schäppi MG, Staiano A, Wilschanski M, Vandenplas Y, ESPGHAN Eosinophilic Esophagitis Working Group and the Gastroenterology Committee (2014) Management guidelines of eosinophilic esophagitis in childhood. J Pediatr Gastroenterol Nutr 58(1):107–118. https://​doi.​org/​10.​1097/​MPG.​0b013e3182a80be1​ PubMedCrossRef
67.
73.
Zurück zum Zitat Katzka DA, Geno DM, Ravi A, Smyrk TC, Lao-Sirieix P, Miramedi A, Debiram I, O’Donovan M, Kita H, Kephart GM, Kryzer LA, Camilleri M, Alexander JA, Fitzgerald RC (2015) Accuracy, safety, and tolerability of tissue collection by cytosponge vs endoscopy for evaluation of eosinophilic esophagitis. Clin Gastroenterol Hepatol 13(1):77–83.e2. https://doi.org/10.1016/j.cgh.2014.06.026 PubMedCrossRef Katzka DA, Geno DM, Ravi A, Smyrk TC, Lao-Sirieix P, Miramedi A, Debiram I, O’Donovan M, Kita H, Kephart GM, Kryzer LA, Camilleri M, Alexander JA, Fitzgerald RC (2015) Accuracy, safety, and tolerability of tissue collection by cytosponge vs endoscopy for evaluation of eosinophilic esophagitis. Clin Gastroenterol Hepatol 13(1):77–83.e2. https://​doi.​org/​10.​1016/​j.​cgh.​2014.​06.​026 PubMedCrossRef
74.
Zurück zum Zitat Furuta GT, Kagalwalla AF, Lee JJ, Alumkal P, Maybruck BT, Fillon S, Masterson JC, Ochkur S, Protheroe C, Moore W, Pan Z, Amsden K, Robinson Z, Capocelli K, Mukkada V, Atkins D, Fleischer D, Hosford L, Kwatia MA, Schroeder S, Kelly C, Lovell M, Melin-Aldana H, Ackerman SJ (2013) The oesophageal string test: a novel, minimally invasive method measures mucosal inflammation in eosinophilic oesophagitis. Gut 62(10):1395–1405. https://doi.org/10.1136/gutjnl-2012-303171 PubMedCrossRef Furuta GT, Kagalwalla AF, Lee JJ, Alumkal P, Maybruck BT, Fillon S, Masterson JC, Ochkur S, Protheroe C, Moore W, Pan Z, Amsden K, Robinson Z, Capocelli K, Mukkada V, Atkins D, Fleischer D, Hosford L, Kwatia MA, Schroeder S, Kelly C, Lovell M, Melin-Aldana H, Ackerman SJ (2013) The oesophageal string test: a novel, minimally invasive method measures mucosal inflammation in eosinophilic oesophagitis. Gut 62(10):1395–1405. https://​doi.​org/​10.​1136/​gutjnl-2012-303171 PubMedCrossRef
82.
Zurück zum Zitat Rafiee P, Theriot ME, Nelson VM, Heidemann J, Kanaa Y, Horowitz SA, Rogaczewski A, Johnson CP, Ali I, Shaker R, Binion DG (2006) Human esophageal microvascular endothelial cells respond to acidic pH stress by PI3K/AKT and p38 MAPK-regulated induction of Hsp70 and Hsp27. Am J Physiol Cell Physiol 291(5):C931–C945. https://doi.org/10.1152/ajpcell.00474.2005 PubMedCrossRef Rafiee P, Theriot ME, Nelson VM, Heidemann J, Kanaa Y, Horowitz SA, Rogaczewski A, Johnson CP, Ali I, Shaker R, Binion DG (2006) Human esophageal microvascular endothelial cells respond to acidic pH stress by PI3K/AKT and p38 MAPK-regulated induction of Hsp70 and Hsp27. Am J Physiol Cell Physiol 291(5):C931–C945. https://​doi.​org/​10.​1152/​ajpcell.​00474.​2005 PubMedCrossRef
85.
86.
Zurück zum Zitat Dellon ES, Speck O, Woodward K, Gebhart JH, Madanick RD, Levinson S, Fritchie KJ, Woosley JT, Shaheen NJ (2013) Clinical and endoscopic characteristics do not reliably differentiate PPI-responsive esophageal eosinophilia and eosinophilic esophagitis in patients undergoing upper endoscopy: a prospective cohort study. Am J Gastroenterol 108(12):1854–1860. https://doi.org/10.1038/ajg.2013.363 PubMedPubMedCentralCrossRef Dellon ES, Speck O, Woodward K, Gebhart JH, Madanick RD, Levinson S, Fritchie KJ, Woosley JT, Shaheen NJ (2013) Clinical and endoscopic characteristics do not reliably differentiate PPI-responsive esophageal eosinophilia and eosinophilic esophagitis in patients undergoing upper endoscopy: a prospective cohort study. Am J Gastroenterol 108(12):1854–1860. https://​doi.​org/​10.​1038/​ajg.​2013.​363 PubMedPubMedCentralCrossRef
89.
Zurück zum Zitat Dvorak AM (1980) Ultrastructural evidence for release of major basic protein-containing crystalline cores of eosinophil granules in vivo: cytotoxic potential in Crohn's disease. J Immunol 125(1):460–462PubMed Dvorak AM (1980) Ultrastructural evidence for release of major basic protein-containing crystalline cores of eosinophil granules in vivo: cytotoxic potential in Crohn's disease. J Immunol 125(1):460–462PubMed
94.
Zurück zum Zitat Canavese G, Villanacci V, Antonelli E, Cadei M, Sapino A, Rocca R, Daperno M, Suriani R, Di Santo MG, Cassoni P, Bernardini N, Bassotti G (2017) Eosinophilia-associated basal plasmacytosis: an early and sensitive histologic feature of inflammatory bowel disease. APMIS 125(3):179–183. https://doi.org/10.1111/apm.12639 PubMedCrossRef Canavese G, Villanacci V, Antonelli E, Cadei M, Sapino A, Rocca R, Daperno M, Suriani R, Di Santo MG, Cassoni P, Bernardini N, Bassotti G (2017) Eosinophilia-associated basal plasmacytosis: an early and sensitive histologic feature of inflammatory bowel disease. APMIS 125(3):179–183. https://​doi.​org/​10.​1111/​apm.​12639 PubMedCrossRef
97.
Zurück zum Zitat Abonia JP, Wen T, Stucke EM, Grotjan T, Griffith MS, Kemme KA, Collins MH, Putnam PE, Franciosi JP, von Tiehl KF, Tinkle BT, Marsolo KA, Martin LJ, Ware SM, Rothenberg ME (2013) High prevalence of eosinophilic esophagitis in patients with inherited connective tissue disorders. J Allergy Clin Immunol 132(2):378–386. https://doi.org/10.1016/j.jaci.2013.02.030 PubMedCrossRef Abonia JP, Wen T, Stucke EM, Grotjan T, Griffith MS, Kemme KA, Collins MH, Putnam PE, Franciosi JP, von Tiehl KF, Tinkle BT, Marsolo KA, Martin LJ, Ware SM, Rothenberg ME (2013) High prevalence of eosinophilic esophagitis in patients with inherited connective tissue disorders. J Allergy Clin Immunol 132(2):378–386. https://​doi.​org/​10.​1016/​j.​jaci.​2013.​02.​030 PubMedCrossRef
100.
Zurück zum Zitat Schoepfer AM, Safroneeva E, Bussmann C et al (2013) Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner. Gastroenterology 145(6):1230–1236 e1–2PubMedCrossRef Schoepfer AM, Safroneeva E, Bussmann C et al (2013) Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner. Gastroenterology 145(6):1230–1236 e1–2PubMedCrossRef
Metadaten
Titel
Eosinophilic Esophagitis Clinical Manifestations and Differential Diagnosis
verfasst von
Diana Muñoz-Mendoza
Adrián Chapa-Rodríguez
Sami L. Bahna
Publikationsdatum
30.12.2017
Verlag
Springer US
Erschienen in
Clinical Reviews in Allergy & Immunology / Ausgabe 1/2018
Print ISSN: 1080-0549
Elektronische ISSN: 1559-0267
DOI
https://doi.org/10.1007/s12016-017-8663-y

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