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Eosinophilic esophagitis : updated consensus recommendations for children and adults

Liacouras, Chris A. and Furuta, Glenn T. and Hirano, Ikuo and Atkins, Dan and Attwood, Stephen E. and Bonis, Peter A. and Burks, A. Wesley and Chehade, Mirna and Collins, Margaret H. and Dellon, Evan S. and Dohil, Ranjan and Falk, Gary W. and Gonsalves, Nirmala and Gupta, Sandeep K. and Katzka, David A. and Lucendo, Alfredo J. and Markowitz, Jonathan E. and Noel, Richard J. and Odze, Robert D. and Putnam, Philip E. and Richter, Joel E. and Romero, Yvonne and Ruchelli, Eduardo and Sampson, Hugh A. and Schoepfer, Alain and Shaheen, Nicholas J. and Sicherer, Scott H. and Spechler, Stuart and Spergel, Jonathan M. and Straumann, Alex and Wershil, Barry K. and Rothenberg, Marc E. and Aceves, Seema S.. (2011) Eosinophilic esophagitis : updated consensus recommendations for children and adults. Journal of allergy and clinical immunology, Vol. 128, H. 1 , S. 3-20.e6.

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Official URL: http://edoc.unibas.ch/dok/A6007635

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Abstract

Eosinophilic esophagitis (EoE) is a clinicopathologic condition of increasing recognition and prevalence. In 2007, a consensus recommendation provided clinical and histopathologic guidance for the diagnosis and treatment of EoE; however, only a minority of physicians use the 2007 guidelines, which require fulfillment of both histologic and clinical features. Since 2007, the number of EoE publications has doubled, providing new disease insight. Accordingly, a panel of 33 physicians with expertise in pediatric and adult allergy/immunology, gastroenterology, and pathology conducted a systematic review of the EoE literature (since September 2006) using electronic databases. Based on the literature review and expertise of the panel, information and recommendations were provided in each of the following areas of EoE: diagnostics, genetics, allergy testing, therapeutics, and disease complications. Because accumulating animal and human data have provided evidence that EoE appears to be an antigen-driven immunologic process that involves multiple pathogenic pathways, a new conceptual definition is proposed highlighting that EoE represents a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. The diagnostic guidelines continue to define EoE as an isolated chronic disorder of the esophagus diagnosed by the need of both clinical and pathologic features. Patients commonly have high rates of concurrent allergic diatheses, especially food sensitization, compared with the general population. Proved therapeutic options include chronic dietary elimination, topical corticosteroids, and esophageal dilation. Important additions since 2007 include genetic underpinnings that implicate EoE susceptibility caused by polymorphisms in the thymic stromal lymphopoietin protein gene and the description of a new potential disease phenotype, proton pump inhibitor-responsive esophageal eosinophila. Further advances and controversies regarding diagnostic methods, surrogate disease markers, allergy testing, and treatment approaches are discussed.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Gastroenterologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Gastroenterologie
UniBasel Contributors:Straumann, Alex
Item Type:Article, refereed
Article Subtype:Further Journal Contribution
Bibsysno:Link to catalogue
Publisher:Mosby
ISSN:0091-6749
Note:Publication type according to Uni Basel Research Database: Journal item
Last Modified:25 Oct 2013 08:32
Deposited On:25 Oct 2013 08:32

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