Article

Eosinophilic Esophagitis

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
New England Journal of Medicine (Impact Factor: 54.42). 09/2004; 351(9):940-1. DOI: 10.1056/NEJM200408263510924
Source: PubMed
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    • "Therefore, it has been suggested that EE is an inflammatory response to a specific diet or to aeroallergens. However, there is a small proportion of EE patients who have no identifiable allergic sensitizations [8] [9]. In the present case, the patient had no history of asthma or allergies, such as those to food, drug, or pollen. "
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    ABSTRACT: Eosinophilic esophagitis (EE) is an increasingly recognized primary clinicopathologic disorder of the esophagus which lacks a specific etiology. Most reports on EE have been limited to the esophagus mucosa. We present a 56-year-old man with the mural form of EE and superficial squamous cell carcinoma in the esophagus. The eosinophils diffusely invaded the full-thickness of the esophagus, mainly infiltrating the muscularis, including the skeletal and smooth muscles. The lesions in the mucosa, submucosa, and adventitia were slight. Although the superficial squamous cell carcinoma was excited by an endoscopic biopsy, there were some changes in the architecture and size of the squamous epithelial cells. The changed cells also expressed the p53 protein. It appears that the eosinophils stimulated cell proliferation, followed by genetic mutations and cancer development. The patient survived with resection of the esophagus and inhaled corticosteroids.
    02/2012; 2012:315428. DOI:10.1155/2012/315428
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    • "The majority of these data are for Eosinophilic Esophagitis (EoE), with considerably less information available for the other EGID subtypes. Pediatric EoE occurs in approximately four out of every 10,000 children (Noel et al., 2004). The age of initial diagnosis varies widely (0–18 years, mean 6.2 years), with higher rates in Caucasians (84%) and males (75%). "
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    ABSTRACT: To characterize caregiver stress (CS) in parents of children with Eosinophilic Gastrointestinal Disorders (EGIDs) and understand relationships with psychological functioning and child behavior. Caregivers with a child (0-17 years) with EGID completed questionnaires for demographics, EGID severity, treatments, CS, psychological distress, self-efficacy, and child behaviors. A total of 163 caregivers (98% mother, 94% Caucasian) participated. CS correlated with psychological distress, income, child behavioral problems, treatments, and disease severity. Children were rated higher than age-specific norms for emotional difficulties. Behavioral difficulties associated with gender, age, EGID severity, and duration. Parent psychological distress was most strongly associated with CS. Parental self-efficacy, dietary treatments, and child emotional difficulties were also related to stress. Mothers reported stress and psychological distress from caring for a child with EGID. The relationship between these variables suggests these parents may benefit from supportive psychotherapy interventions. Evaluation of parental self-efficacy and child behavior is also warranted.
    Journal of Pediatric Psychology 01/2012; 37(5):523-32. DOI:10.1093/jpepsy/jsr118 · 2.91 Impact Factor
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    • "A more recent study by Prasad and colleagues showed a prevalence of 15% in patients with a complaint of dysphagia [Prasad et al. 2007]. Many of these studies have also shown an increasing prevalence of EoE since its identification [Prasad et al. 2009; Ronkainen et al. 2007; Cherian et al. 2006; Straumann and Simon, 2005; Noel et al. 2004]. It is unclear whether or not there is a true increase in prevalence or an increased awareness of EoE, leading to increased numbers of diagnoses made. "
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    ABSTRACT: Background: Eosinophilic esophagitis (EoE) is a clinicopathologic disorder first described in 1978 which has gained significant recognition over the past 10 years. Numerous prevalence studies have been performed around the globe, both in pediatric and adult populations documenting a prevalence between 0.002% and 6.5%. The aim of this study is to assess the utility of routinely screening for EoE in patients with dysphagia.Methods: A prospective, observational study in which adult patients with a complaint of esophageal dysphagia were enrolled.Results: Of the 135 patients enrolled, 122 completed the study; 100 patients had nonobstructive dysphagia, while 22 patients had a luminal finding which could explain their dysphagia. The prevalence of EoE in the nonobstructive dysphagia group was 22% (95% CI: 13.9-30.1%); 32.7% of male patients with nonobstructive dysphagia were found to have EoE compared with 8.9% of females (p = 0.004). The mean age of nonobstructive patients found to have EoE was 37.8 years. White patients with nonobstructive dysphagia were found to have a 25.9% prevalence of EoE, compared with 0% of African Americans, 0% of Asians, and 14.3% of Hispanics. When comparing Whites with non-Whites, the prevalence of EoE was noted to be 25.9% versus 5.3%, respectively (p = 0.050).Conclusions: EoE is a common cause of nonobstructive dysphagia. We believe that the high prevalence of EoE in patients with nonobstructive dysphagia supports the practice of routine biopsies to screen for the presence of abnormally high numbers of eosinophils in this subgroup.
    Therapeutic Advances in Gastroenterology 01/2011; 4(1):27-35. DOI:10.1177/1756283X10384172
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