scholarly journals Eosinophilic Esophagitis: Atopy Conditions of the Esophagus

2021 ◽  
Vol 2 (3) ◽  
pp. 154-166
Author(s):  
Puspa Zuleika
Keyword(s):  
United States ◽  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
The United States ◽  
Esophageal Stenosis ◽  
Esophageal Mucosa ◽  
High Power Field ◽  
Immune Mediated ◽  
Food Antigens ◽  
Delays In Diagnosis

Eosinophilic esophagitis is an immune-allergic pathology of multifactorial etiology(genetic and environmental) characterized by major symptoms of esophagealdysphagia and eosinophil-predominant inflammation of the esophageal mucosathat affects both pediatric and adult patients. EoE is an immune-mediated diseaseby which environmental and food antigens stimulate the Th2 inflammatorycascade. It is correlated with food allergy and atopy condition such as asthma, atopydermatitis, rhinitis allergic and often in conjunction with Gastroesophageal RefluxDisease (GERD). Eosinophilic esophagitis (EoE) was first described in the 1990s,showing an increasing incidence and prevalence since then, in the United States isestimated to be approximately 57 per 100,000 persons being the leading cause offood impaction and the major cause of dysphagia. Its symptoms, which includeheartburn, regurgitation, and esophageal stenosis. This symptomps similar to thoseof gastroesophageal reflux disease, causing delays in diagnosis and treatment. Theendoscopic findings such as furrows, esophageal mucosa trachealization, andwhitish exudates, this diagnosis should be confirmed histologically confirmed bybiopsy on the presence of more than 15 eosinophils per high-power field and theexclusion of other causes of eosinophilia. Management includes medications, diet,and surgical dilatation.

Eosinophilic Esophagitis: Atopy Conditions of the Esophagus

2021 ◽  
Vol 2 (1) ◽  
pp. 146-157
Author(s):  
Puspa Zuleika
Keyword(s):  
Eosinophilic Esophagitis ◽  
Reflux Disease ◽  
The United States ◽  
Esophageal Stenosis ◽  
Esophageal Mucosa ◽  
High Power Field ◽  
Inflammatory Cascade ◽  
Immune Mediated ◽  
Food Antigens ◽  
Delays In Diagnosis

A B S T R A C TEosinophilic esophagitis is an immune-allergic pathology of multifactorial etiology(genetic and environmental) characterized by major symptoms of esophagealdysphagia and eosinophil-predominant inflammation of the esophageal mucosa thataffects both pediatric and adult patients. EoE is an immune-mediated disease bywhich environmental and food antigens stimulate the Th2 inflammatory cascade. It iscorrelated with food allergy and atopy condition such as asthma, atopy dermatitis,rhinitis allergic and often in conjunction with Gastroesophageal Reflux Disease(GERD). Eosinophilic esophagitis (EoE) was first described in the 1990s, showing anincreasing incidence and prevalence since then, in the United States is estimated tobe approximately 57 per 100,000 persons being the leading cause of food impactionand the major cause of dysphagia. Its symptoms, which include heartburn,regurgitation, and esophageal stenosis. This symptomps similar to those ofgastroesophageal reflux disease, causing delays in diagnosis and treatment. Theendoscopic findings such as furrows, esophageal mucosa trachealization, and whitishexudates, this diagnosis should be confirmed histologically confirmed by biopsy onthe presence of more than 15 eosinophils per high-power field and the exclusion ofother causes of eosinophilia. Management includes medications, diet, and surgicaldilatation.

scholarly journals Eosinofilik Esofagitis

2013 ◽  
Vol 2 (3) ◽  
pp. 183
Author(s):  
Yusri Dianne Jurnalis ◽  
Yorva Sayoeti ◽  
Widiasteti Widiasteti
Keyword(s):  
Food Allergy ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Eosinophilic Esophagitis ◽  
High Power ◽  
Reflux Disease ◽  
Eosinophil Infiltration ◽  
Esophageal Mucosa ◽  
High Power Field ◽  
Histologic Diagnosis

AbstrakEosinofilik esofagitis merupakan gangguan dimana terjadi infiltrasi eosinofil pada mukosa superfisial esophagus yang berhubungan dengan alergi makanan dan kondisi atopi seperti asma, dermatitis atopi, rhinitis alergika dan sering bersamaan dengan Gastroesophageal Reflux Disease (GERD). Diperkirakan insiden tahunan 43 per 10.000 pada anak. Gejala klinis mirip dengan GERD yaitu muntah, regurgitasi, nausea, nyeri dada atau epigastrium, disfagia dan hematemesis. Sekitar 50% pasien memiliki gejala alergi dan lebih 50% pasien memiliki orang tua dengan riwayat alergi. Diagnosis dapat ditegakkan berdasarkan pemeriksaan endoskopi dan histologis. Gambaran endoskopi yang ditemukan antara lain feline esophagus, corrugated esophagus, ringed esophagus, atau concentric mucosal rings, eksudat putih, vesikel atau papul dan hilangnya pola vaskular menunjukkan area fokus infiltrasi eosinofil. Diagnosis secara histologis sangat penting dimana kriteria eosinofilik esofagitis adalah jika ditemukan eosinofil >20/HPF (High Power Field). Terapi yang diberikan adalah terapi diet, farmakologis seperti kortikosteroid sistemik atau topikal, penghambat reseptor leukotrin dan anti IL-5.Kata kunci: eosinofilik esofagitis, alergi makanan, atopiAbstractEosinophilic esophagitis is a disorder which there is eosinophil infiltration on superficial esophageal mucosa. It’s correlated with food allergy and atopy condition such as asthma, atopy dermatitis, rhinitis allergic and often in conjunction with Gastroesophageal Reflux Disease ( GERD). The incidence approximately 43/10.000 in children. The symptoms are similar with GERD, which one vomit, regurgitation, nausea, chest or epigastrium pain, dysphagia and hematemesis. About 50% patient has allergic symptoms and more than 50% parent of the patient has allergic history. The diagnose can be made base on endoscopic and histological examination. Endoscopic examination shows feline esophagus, corrugated esophagus or concentric mucosal rings, white exudates, vesikel or papul and diminished of vascular pattern, showing eosinophyl infiltration focus area. Histologic diagnosis is very important where the criteria for eosinophilic esophagitis is found eosinophils > 20 / HPF (High Power Field) within the superficial esophageal mucosa. Therapy eosinophilic esophagitis are diet therapy, pharmacological therapy with systemic or topical corticosteroid, leucotriene receptor antagonist and anti IL-5.Keywords:Eosinophilic esophagitis, food allergy, atopy

Food Allergies

2018 ◽  
Author(s):  
Matthew Greenhawt
Keyword(s):  
United States ◽  
Adverse Reaction ◽  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Adverse Reactions ◽  
Action Plan ◽  
The United States ◽  
Oral Allergy Syndrome ◽  
Food Allergies ◽  
Food Protein

Food allergy represents a rapidly growing public health problem in the United States and other westernized nations. Adverse reactions to foods are categorized as either immunologic or nonimmunologic reactions. This distinction is highly important but often confusing to patients and physicians unfamiliar with allergy, who may simply describe any adverse reaction to a food as an “allergy.” A food allergy is an immune-mediated, adverse reaction to one or more protein allergens in a particular food item involving recognition of that protein by specifically targeted IgE or allergen-specific T cells. This chapter discusses the definition, pathophysiology, epidemiology, testing, management, prognosis, and natural history of food allergy. Clinical manifestations are systematically covered, including cutaneous, respiratory, cardiovascular, and gastrointestinal reactions, as well as eosinophilic esophagitis, food protein–induced enterocolitis syndrome, and oral allergy syndrome. Emerging treatments such as food oral immunotherapy are also reviewed. Tables outline signs and symptoms of immediate hypersensitivity reactions to food, the prevalence of major food allergens in the United States, common patterns of cross-reactivity among foods, clinical criteria for the diagnosis of anaphylaxis, and clinical studies involving treatment for food allergies. Figures illustrate the classification of adverse reactions to food, esophageal histology, visual and radiographic features of eosinophilic esophagitis, and a food allergy action plan. This review contains 4 figures, 8 tables, and 64 references. KeyWords: Food allergy, Hypersensitivity, IgE-mediated allergy, Eosinophilic esophagitis, Anaphylaxis

scholarly journals Clinical Guidelines of the Russian Gastroenterological Association on the Diagnostics and Treatment of Eosinophilic Esophagitis

2019 ◽  
Vol 28 (6) ◽  
pp. 84-98 ◽  
Author(s):  
V. T. Ivashkin ◽  
I. V. Maev ◽  
A. S. Trukhmanov ◽  
T. L. Lapina ◽  
D. N. Andreev ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Clinical Manifestations ◽  
Eosinophilic Infiltration ◽  
Esophageal Mucosa ◽  
High Power Field ◽  
Immune Mediated ◽  
Esophageal Dysfunction ◽  
Diagnostic Criterion ◽  
Choice Of Therapy

Aim.This paper presents guidelines on the diagnostics and treatment of eosinophilic esophagitis, which can be used by practitioners in their everyday practice.Summary.Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus characterized by the symptoms of esophageal dysfunction and a pronounced eosinophilic infiltration of the esophageal mucosa. The EoE diagnostics is based on the clinical manifestations of the disease (dysphagia, food impaction, chest pain regardless of swallowing), as well as on the combination of endoscopic and histological signs. The diagnostic criterion is the eosinophilic infiltration of the esophageal mucosa with an eosinophil density of ≥ 15 per high power field (×400) in at least one of the biopsy specimens (about 60 eosinophils in 1 mm2). Total IgE levels, peripheral blood eosinophilia and skin allergy tests are considered to be additional diagnostic means. Several approaches are used for the treatment of EoE, including proton pump inhibitors (PPIs) and topical glucocorticosteroids (GCS), as well as elimination diets. The choice of therapy should be individualized, with the mandatory assessment of the treatment efficacy after 6–12 weeks using esophagogastroduodenoscopy with biopsy sampling. Endoscopic dilatation should be considered in patients suffering from severe dysphagia due to esophagus stricture.Conclusion.Increased incidence of EoE predominantly among children and young people, as well as its chronic character requiring long-term maintenance therapy, make EoE a significant issue to the practice of gastroenterology.

Food Allergies

2018 ◽  
Author(s):  
Matthew Greenhawt
Keyword(s):  
United States ◽  
Adverse Reaction ◽  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Adverse Reactions ◽  
Action Plan ◽  
The United States ◽  
Oral Allergy Syndrome ◽  
Food Allergies ◽  
Food Protein

Food allergy represents a rapidly growing public health problem in the United States and other westernized nations. Adverse reactions to foods are categorized as either immunologic or nonimmunologic reactions. This distinction is highly important but often confusing to patients and physicians unfamiliar with allergy, who may simply describe any adverse reaction to a food as an “allergy.” A food allergy is an immune-mediated, adverse reaction to one or more protein allergens in a particular food item involving recognition of that protein by specifically targeted IgE or allergen-specific T cells. This chapter discusses the definition, pathophysiology, epidemiology, testing, management, prognosis, and natural history of food allergy. Clinical manifestations are systematically covered, including cutaneous, respiratory, cardiovascular, and gastrointestinal reactions, as well as eosinophilic esophagitis, food protein–induced enterocolitis syndrome, and oral allergy syndrome. Emerging treatments such as food oral immunotherapy are also reviewed. Tables outline signs and symptoms of immediate hypersensitivity reactions to food, the prevalence of major food allergens in the United States, common patterns of cross-reactivity among foods, clinical criteria for the diagnosis of anaphylaxis, and clinical studies involving treatment for food allergies. Figures illustrate the classification of adverse reactions to food, esophageal histology, visual and radiographic features of eosinophilic esophagitis, and a food allergy action plan. This review contains 4 figures, 8 tables, and 64 references. KeyWords: Food allergy, Hypersensitivity, IgE-mediated allergy, Eosinophilic esophagitis, Anaphylaxis

scholarly journals Breaking the Paradox: Comparing Food Allergy Prevalence Among Latino Sub-Groups in the United States

2020 ◽  
Vol 145 (2) ◽  
pp. AB182
Author(s):  
Andrea Pappalardo ◽  
Christopher Warren ◽  
Jialing Jiang ◽  
Ruchi Gupta
Keyword(s):  
United States ◽  
Food Allergy ◽  
The United States ◽  
Allergy Prevalence

scholarly journals Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report

2011 ◽  
Vol 31 (1) ◽  
pp. 61-75 ◽  
Author(s):  
Joshua A. Boyce ◽  
Amal Assa'ad ◽  
A. Wesley Burks ◽  
Stacie M. Jones ◽  
Hugh A. Sampson ◽  
...  
Keyword(s):  
United States ◽  
Food Allergy ◽  
Expert Panel ◽  
The United States ◽  
Panel Report ◽  
Diagnosis And Management
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