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Current Gastroenterology Reports

Erschienen in:

01.08.2021 | Stomach and Duodenum (J Pisegna and J Benhammou, Section Editors)

Eosinophilic Gastritis/Gastroenteritis

verfasst von: Phillip H. Chen, Lorraine Anderson, Kuixing Zhang, Guy A. Weiss

Erschienen in: Current Gastroenterology Reports | Ausgabe 8/2021

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Abstract

Purpose of Review

Eosinophilic gastritis/gastroenteritis (EG/EGE) are rare eosinophilic infiltrative disorders in children and adults that fall under the umbrella term eosinophilic gastrointestinal disorders (EGIDs). EGIDs also include eosinophilic esophagitis (EoE) and eosinophilic colitis. In this article, we present the current literature regarding the clinical presentation, diagnostic criteria, and management of EG/EGE.

Recent Findings

The underlying complex pathophysiology remains unknown, yet hypersensitivity response is a central component. Unlike EoE, standardized diagnostic criteria are lacking but, promising research employing tissue-based and blood-based methods of diagnosis have been reported. Non-EoE EGIDs are more challenging to treat than EoE. More than a third of patients may achieve spontaneous remission. Still, most will require dietary elimination and/or pharmaceutical interventions, mainly corticosteroids, but also biologics (monoclonal antibodies against IL-4, IL-5, TNFα, integrin α4β7, and IgE), mast-cell stabilizers, leukotriene (LT)-receptor antagonists, and antihistamines. Promising research suggests the role of AK002, an anti-siglec antibody, in clinical and histological improvement.

Summary

Given the rarity and underdiagnosis of EG/EGE, different natural progression compared to EoE, heterogeneous clinical manifestations, and probable normal endoscopic appearance, it is vital to maintain a high suspicion index in atopic patients, obtain at least 5–6 random biopsies from each site for gastro/duodenal eosinophilic infiltrate with the subsequent exclusion of inflammatory, allergic and infectious differential diagnoses to increase the yield of an accurate diagnosis. Corticosteroids remain the mainstay of treatment, often requiring long-term use. Steroid-sparing agents remain experimental. Goals of therapy move beyond clinical remission but lack evidence to support histological remission.

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Titel: Eosinophilic Gastritis/Gastroenteritis
verfasst von: Phillip H. Chen
Lorraine Anderson
Kuixing Zhang
Guy A. Weiss
Publikationsdatum: 01.08.2021
Verlag: Springer US
Erschienen in: Current Gastroenterology Reports / Ausgabe 8/2021
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI: https://doi.org/10.1007/s11894-021-00809-2

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Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Eosinophilic Gastritis/Gastroenteritis