Диагностика и лечение эозинофильного эзофагита: обзор Европейских рекомендаций 2017 г.
Диагностика и лечение эозинофильного эзофагита: обзор Европейских рекомендаций 2017 г.
Маев И.В., Дичева Д.Т., Андреев Д.Н. и др. Диагностика и лечение эозинофильного эзофагита: обзор Европейских рекомендаций 2017 г. Consilium Medicum. 2019; 21 (8): 9–14. DOI: 10.26442/20751753.2019.8.190499
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Maev I.V., Dicheva D.T., Andreev D.N. et al. Eosinophilic esophagitis diagnostics and treatment: review of the 2017 European guidelines. Consilium Medicum. 2019; 21 (8): 9–14. DOI: 10.26442/20751753.2019.8.190499
Диагностика и лечение эозинофильного эзофагита: обзор Европейских рекомендаций 2017 г.
Маев И.В., Дичева Д.Т., Андреев Д.Н. и др. Диагностика и лечение эозинофильного эзофагита: обзор Европейских рекомендаций 2017 г. Consilium Medicum. 2019; 21 (8): 9–14. DOI: 10.26442/20751753.2019.8.190499
________________________________________________
Maev I.V., Dicheva D.T., Andreev D.N. et al. Eosinophilic esophagitis diagnostics and treatment: review of the 2017 European guidelines. Consilium Medicum. 2019; 21 (8): 9–14. DOI: 10.26442/20751753.2019.8.190499
Эозинофильный эзофагит – это хроническое иммуноопосредованное заболевание пищевода, характеризующееся симптомами эзофагеальной дисфункции и выраженной эозинофильной инфильтрацией слизистой оболочки органа. Целью данной обзорной статьи является освещение для российских специалистов основных позиций по диагностике и лечению эозинофильного эзофагита, регламентированных Европейскими рекомендациями 2017 г.
Eosinophilic esophagitis is a chronic immune-mediated disorder of the esophagus that is characterized by esophagus dysfunction symptoms and severe eosinophile infiltration of the organ mucosa. The aim of the present review article was to present Russian medical practitioners the main points of diagnostics and treatment of eosinophilic esophagitis that are specified in 2017 European guidelines.
1. Ивашкин В.Т., Баранская Е.К., Кайбышева В.О. и др. Эозинофильный эзофагит: обзор литературы и описание собственного наблюдения. Рос. журн. гастроэнтерологии, гепатологии, колопроктологии. 2012; 1: 71–81.
[Ivashkin V.T., Baranskaia E.K., Kaibysheva V.O. et al. Eozinofil'nyi ezofagit: obzor literatury i opisanie sobstvennogo nabliudeniia. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2012; 1: 71–81 (in Russian).]
2. Goyal A. Eosinophilic esophagitis: short and long-term considerations. Curr Opin Pediatr 2018; 30 (5): 646–52. DOI: 10.1097/MOP.0000000000000662
3. Трухманов А.С. Эозинофильный эзофагит. В кн.: Справочник по гастроэнтерологии. Под ред. В.Т.Ивашкина, С.И.Рапопорта. Изд. 2-е. М.: МИА, 2011; с. 48–9.
[Trukhmanov A.S. Eosinophilic esophagitis. In: Handbook of gastroenterology. Ed. V.T.Ivashkin, S.I.Rapoport. Edition 2nd. Moscow: MIA, 2011; p. 48–9. (in Russian).]
4. Ивашкин В.Т., Маев И.В., Трухманов А.С. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению эозинофильного эзофагита. Рос. журн. гастроэнтерологии, гепатологии, колопроктологии. 2018; 28 (6): 84–98.
[Ivashkin V.T., Maev I.V., Trukhmanov A.S. et al. Klinicheskie rekomendatsii Rossiiskoi gastroenterologicheskoi assotsiatsii po diagnostike i lecheniiu eozinofil'nogo ezofagita. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2018; 28 (6): 84–98 (in Russian).]
5. Кайбышева В.О., Кашин С.В., Михалева Л.М. и др. Эозинофильный эзофагит: современный взгляд на проблему и собственные клинические наблюдения. Доказательная гастроэнтерология. 2019; 8 (1): 58–83.
[Kaibysheva V.O., Kashin S.V., Mikhaleva L.M. et al. Eozinofil'nyi ezofagit: sovremennyi vzgliad na problemu i sobstvennye klinicheskie nabliudeniia. Dokazatel'naia gastroenterologiia. 2019; 8 (1): 58–83 (in Russian).]
6. Маев И.В., Бусарова Г.А., Андреев Д.Н. Болезни пищевода. М.: ГЭОТАР-Медиа, 2019.
[Maev I.V., Busarova G.A., Andreev D.N. Diseases of the esophagus. Moscow: GEOTAR-Media, 2019 (in Russian).]
7. Lucendo AJ, Molina-Infante J, Arias Á et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United Eur Gastroenterol J 2017; 5 (3): 335–58. DOI: 10.1177/2050640616689525
8. Трухманов А.С., Ивашкина Н.Ю. Эозинофильный эзофагит. Рациональная фармакотерапия заболеваний органов пищеварения. Под. ред. В.Т.Ивашкина. М.: Литерра, 2011; с. 267–9.
[Trukhmanov A.S., Ivashkina N.Iu. Eosinophilic esophagitis. Rational pharmacotherapy of digestive diseases. Ed. V.T.Ivashkin. Moscow: Literra, 2011; p. 267–9 (in Russian).]
9. Straumann A, Spichtin HP, Bernoulli R et al. Idiopathic eosinophilic esophagitis: a frequently overlooked disease with typical clinical aspects and discrete endoscopic findings. Schweiz Med Wochenschr 1994; 124: 1419–29.
10. Furuta GT, Liacouras CA, Collins MH et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology 2007; 133: 1342–63.
11. Liacouras CA, Furuta GT, Hirano I et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol 2011; 128: 3–20.
12. Papadopoulou A, Koletzko S, Heuschkel R et al. Management guidelines of eosinophilic esophagitis in childhood. J Pediatr Gastroenterol Nutr 2014; 58: 107–18.
13. Dellon ES, Gonsalves N, Hirano I et al. ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol 2013; 108: 679–92.
14. Lipka S, Keshishian J, Boyce HW et al. The natural history of steroid-naive eosinophilic esophagitis in adults treated with endoscopic dilation and proton pump inhibitor therapy over a mean duration of nearly 14 years. Gastrointest Endosc 2014; 80: 592–8.
15. Harris RF, Menard-Katcher C, Atkins D et al. Psychosocial dysfunction in children and adolescents with eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2013; 57: 500–5.
16. Klinnert MD, Silveira L, Harris R et al. Health-related quality of life over time in children with eosinophilic esophagitis and their families. J Pediatr Gastroenterol Nutr 2014; 59: 308–16.
17. Arias A, Perez-Martinez I, Tenias JM et al. Systematic review with meta-analysis: the incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Aliment Pharmacol Ther 2016; 43: 3–15.
18. Veerappan GR, Perry JL, Duncan TJ et al. Prevalence of eosinophilic esophagitis in an adult population undergoing upper endoscopy: a prospective study. Clin Gastroenterol Hepatol 2009; 7: 420–6.
19. Dellon ES. Epidemiology of eosinophilic esophagitis. Gastroenterol Clin North Am 2014; 43: 201–18.
20. Foroutan M, Norouzi A, Molaei M et al. Eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease. Dig Dis Sci 2010; 55: 28–31.
21. Achem SR, Almansa C, Krishna M et al. Oesophageal eosinophilic infiltration in patients with noncardiac chest pain. Aliment Pharmacol Ther 2011; 33: 1194–201.
22. Ricker J, McNear S, Cassidy T et al. Routine screening for eosinophilic esophagitis in patients presenting with dysphagia. Therap Adv Gastroenterol 2011; 4: 27–35.
23. Savarino E, Tolone S, Caccaro R et al. Clinical, endoscopic, histological and radiological characteristics of Italian patients with eosinophilic oesophagitis. Dig Liver Dis 2015; 47: 1033–8.
24. Kerlin P, Jones D, Remedios M et al. Prevalence of eosinophilic esophagitis in adults with food bolus obstruction of the esophagus. J Clin Gastroenterol 2007; 41: 356–61.
25. Prasad GA, Alexander JA, Schleck CD et al. Epidemiology of eosinophilic esophagitis over three decades in Olmsted County, Minnesota. Clin Gastroenterol Hepatol 2009; 7: 1055–61.
26. Kapel RC, Miller JK, Torres C et al. Eosinophilic esophagitis: a prevalent disease in the United States that affects all age groups. Gastroenterology 2008; 134: 1316–21.
27. Castro Jimenez A, Gomez Torrijos E, Garcia Rodriguez R et al. Demographic, clinical and allergological characteristics of Eosinophilic Esophagitis in a Spanish central region. Allergol Immunopathol (Madr) 2014; 42: 407–14.
28. van Rhijn BD, Verheij J, Smout AJ et al. Rapidly increasing incidence of eosinophilic esophagitis in a large cohort. Neurogastroenterol Motil 2013; 25: 47–52.
29. González-Cervera J, Arias Á, Redondo-González O et al. The association between atopic manifestations and eosinophilic esophagitis: a systematic review and meta-analysis. Ann Allergy Asth Immunol 2017; 118 (5): 582–90. DOI: 10.1016/j.anai.2017.02.006
30. Remedios M, Campbell C, Jones DM et al. Eosinophilic esophagitis in adults: clinical, endoscopic, histologic findings, and response to treatment with fluticasone propionate. Gastrointest Endosc 2006; 63: 3–12.
31. Croese J, Fairley SK, Masson JW et al. Clinical and endoscopic features of eosinophilic esophagitis in adults. Gastrointest Endosc 2003; 58: 516–22.
32. Spergel JM, Brown-Whitehorn TF, Beausoleil JL et al. 14 years of eosinophilic esophagitis: clinical features and prognosis. J Pediatr Gastroenterol Nutr 2009; 48: 30–6.
33. Saffari H, Peterson KA, Fang JC et al. Patchy eosinophil distributions in an esophagectomy specimen from a patient with eosinophilic esophagitis: Implications for endoscopic biopsy. J Allergy Clin Immunol 2012; 130: 798–800.
34. Nielsen JA, Lager DJ, Lewin M et al. The optimal number of biopsy fragments to establish a morphologic diagnosis of eosinophilic esophagitis. Am J Gastroenterol 2014; 109: 515–20.
35. Salek J, Clayton F, Vinson Let al. Endoscopic appearance and location dictate diagnostic yield of biopsies in eosinophilic oesophagitis. Aliment Pharmacol Ther 2015; 41: 1288–95.
36. Dellon ES, Speck O, Woodward K et al. Distribution and variability of esophageal eosinophilia in patients undergoing upper endoscopy. Mod Pathol 2015; 28: 383–90.
37. Fiocca R, Mastracci L, Engström C et al. Long-term outcome of microscopic esophagitis in chronic GERD patients treated with esomeprazole or laparoscopic antireflux surgery in the LOTUS trial. Am J Gastroenterol 2010; 105: 1015–23.
38. Kim HP, Dellon ES. An Evolving Approach to the Diagnosis of Eosinophilic Esophagitis. Gastroenterol Hepatol (NY) 2018; 14 (6): 358–66.
39. Saffari H, Hoffman LH, Peterson KA et al. Electron microscopy elucidates eosinophil degranulation patterns in patients with eosinophilic esophagitis. J Allergy Clin Immunol 2014; 133: 1728–34.
40. Capocelli KE, Fernando SD, Menard-Katcher C et al. Ultrastructural features of eosinophilic oesophagitis: impact of treatment on desmosomes. J Clin Pathol 2015; 68: 51–6.
41. Collins MH. Histopathologic features of eosinophilic esophagitis and eosinophilic gastrointestinal diseases. Gastroenterol Clin North Am 2014; 43: 257–68.
42. Safroneeva E, Straumann A, Coslovsky M et al. Symptoms have modest accuracy in detecting endoscopic and histologic remission in adults with eosinophilic esophagitis. Gastroenterology 2016; 150: 581–90.
43. Kim HP, Vance RB, Shaheen NJ et al. The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. Clin Gastroenterol Hepatol 2012; 10: 988–96.
44. Liacouras CA, Spergel JM, Ruchelli E et al. Eosinophilic esophagitis: A 10-year experience in 381 children. Clin Gastroenterol Hepatol 2005; 3: 1198–206.
45. Lucendo AJ, Arias A, Molina-Infante J. Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 13–22.
46. Molina-Infante J, Ferrando-Lamana L, Ripoll C et al. Esophageal eosinophilic infiltration responds to proton pump inhibition in most adults. Clin Gastroenterol Hepatol 2011; 9: 110–17.
47. Dellon ES, Liacouras CA. Advances in clinical management of eosinophilic esophagitis. Gastroenterology 2014; 147: 1238–54.
48. Schaefer ET, Fitzgerald JF, Molleston JP et al. Comparison of oral prednisone and topical fluticasone in the treatment of eosinophilic esophagitis: a randomized trial in children. Clin Gastroenterol Hepatol 2008; 6: 165–73.
49. Tan N Di, Xiao YL, Chen MH. Steroids therapy for eosinophilic esophagitis: Systematic review and meta-analysis. J Dig Dis 2015; 16: 431–42.
50. Sawas T, Dhalla S, Sayyar M et al. Systematic review with meta-analysis: pharmacological interventions for eosinophilic oesophagitis. Aliment Pharmacol Ther 2015; 41: 797–806.
51. Murali AR, Gupta A, Attar BM et al. Topical steroids in eosinophilic esophagitis: systematic review and meta-analysis of placebo controlled randomized clinical trials. J Gastroenterol Hepatol 2015; 31: 1111–9.
52. Chuang M-YA, Chinnaratha MA, Hancock DG et al. Topical steroid therapy for the treatment of eosinophilic esophagitis (EoE): a systematic review and meta-analysis. Clin Transl Gastroenterol 2015; 6: e82.
53. Straumann A, Conus S, Degen L et al. Long-term budesonide maintenance treatment is partially effective for patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol 2011; 9: 400–9.
54. Kagalwalla AF, Sentongo TA, Ritz S et al. Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Clin Gastroenterol Hepatol 2006; 4: 1097–102.
55. Henderson CJ, Abonia JP, King EC et al. Comparative dietary therapy effectiveness in remission of pediatric eosinophilic esophagitis. J Allergy Clin Immunol 2012; 129: 1570–8.
56. Wolf WA, Jerath MR, Sperry SLW et al. Dietary elimination therapy is an effective option for adults with eosinophilic esophagitis. Clin Gastroenterol Hepatol 2014; 12: 1272–9.
57. Arias A, Gonzalez-Cervera J, Tenias JM et al. Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis. Gastroenterology 2014; 146: 1639–48.
58. Molina-Infante J, Arias A, Barrio J et al. Four-food group elimination diet for adult eosinophilic esophagitis: A prospective multicenter study. J Allergy Clin Immunol 2014; 134: 1093–99.
59. Molina-Infante J, Modolell I, Alcedo J et al. Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: the 2-4-6 study. United Eur Gastroenterol J 2016; Suppl. 5: A126.
60. Gonsalves N, Yang G-Y, Doerfler B et al. Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors. Gastroenterology 2012; 142: 1451–5.
61. Lucendo AJ, Arias A, Gonzalez-Cervera J et al. Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: a prospective study on the food cause of the disease. J Allergy Clin Immunol 2013; 131: 797–804.
62. Kagalwalla AF, Shah A, Li BUK et al. Identification of specific foods responsible for inflammation in children with eosinophilic esophagitis successfully treated with empiric elimination diet. J Pediatr Gastroenterol Nutr 2011; 53: 145–9.
63. Moawad FJ, Cheatham JG, DeZee KJ. Meta-analysis: the safety and efficacy of dilation in eosinophilic oesophagitis. Aliment Pharmacol Ther 2013; 38: 713–20.
64. Netzer P, Gschossmann JM, Straumann A et al. Corticosteroid-dependent eosinophilic oesophagitis: azathioprine and 6-mercaptopurine can induce and maintain long-term remission. Eur J Gastroenterol Hepatol 2007; 19: 865–9.07; 19: 865–9.
________________________________________________
1. Ivashkin V.T., Baranskaia E.K., Kaibysheva V.O. et al. Eozinofil'nyi ezofagit: obzor literatury i opisanie sobstvennogo nabliudeniia. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2012; 1: 71–81 (in Russian).
2. Goyal A. Eosinophilic esophagitis: short and long-term considerations. Curr Opin Pediatr 2018; 30 (5): 646–52. DOI: 10.1097/MOP.0000000000000662
3. Trukhmanov A.S. Eosinophilic esophagitis. In: Handbook of gastroenterology. Ed. V.T.Ivashkin, S.I.Rapoport. Edition 2nd. Moscow: MIA, 2011; p. 48–9. (in Russian).
4. Ivashkin V.T., Maev I.V., Trukhmanov A.S. et al. Klinicheskie rekomendatsii Rossiiskoi gastroenterologicheskoi assotsiatsii po diagnostike i lecheniiu eozinofil'nogo ezofagita. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2018; 28 (6): 84–98 (in Russian).
5. Kaibysheva V.O., Kashin S.V., Mikhaleva L.M. et al. Eozinofil'nyi ezofagit: sovremennyi vzgliad na problemu i sobstvennye klinicheskie nabliudeniia. Dokazatel'naia gastroenterologiia. 2019; 8 (1): 58–83 (in Russian).
6. Maev I.V., Busarova G.A., Andreev D.N. Diseases of the esophagus. Moscow: GEOTAR-Media, 2019 (in Russian).
7. Lucendo AJ, Molina-Infante J, Arias Á et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United Eur Gastroenterol J 2017; 5 (3): 335–58. DOI: 10.1177/2050640616689525
8. Trukhmanov A.S., Ivashkina N.Iu. Eosinophilic esophagitis. Rational pharmacotherapy of digestive diseases. Ed. V.T.Ivashkin. Moscow: Literra, 2011; p. 267–9 (in Russian).
9. Straumann A, Spichtin HP, Bernoulli R et al. Idiopathic eosinophilic esophagitis: a frequently overlooked disease with typical clinical aspects and discrete endoscopic findings. Schweiz Med Wochenschr 1994; 124: 1419–29.
10. Furuta GT, Liacouras CA, Collins MH et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology 2007; 133: 1342–63.
11. Liacouras CA, Furuta GT, Hirano I et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol 2011; 128: 3–20.
12. Papadopoulou A, Koletzko S, Heuschkel R et al. Management guidelines of eosinophilic esophagitis in childhood. J Pediatr Gastroenterol Nutr 2014; 58: 107–18.
13. Dellon ES, Gonsalves N, Hirano I et al. ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol 2013; 108: 679–92.
14. Lipka S, Keshishian J, Boyce HW et al. The natural history of steroid-naive eosinophilic esophagitis in adults treated with endoscopic dilation and proton pump inhibitor therapy over a mean duration of nearly 14 years. Gastrointest Endosc 2014; 80: 592–8.
15. Harris RF, Menard-Katcher C, Atkins D et al. Psychosocial dysfunction in children and adolescents with eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2013; 57: 500–5.
16. Klinnert MD, Silveira L, Harris R et al. Health-related quality of life over time in children with eosinophilic esophagitis and their families. J Pediatr Gastroenterol Nutr 2014; 59: 308–16.
17. Arias A, Perez-Martinez I, Tenias JM et al. Systematic review with meta-analysis: the incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Aliment Pharmacol Ther 2016; 43: 3–15.
18. Veerappan GR, Perry JL, Duncan TJ et al. Prevalence of eosinophilic esophagitis in an adult population undergoing upper endoscopy: a prospective study. Clin Gastroenterol Hepatol 2009; 7: 420–6.
19. Dellon ES. Epidemiology of eosinophilic esophagitis. Gastroenterol Clin North Am 2014; 43: 201–18.
20. Foroutan M, Norouzi A, Molaei M et al. Eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease. Dig Dis Sci 2010; 55: 28–31.
21. Achem SR, Almansa C, Krishna M et al. Oesophageal eosinophilic infiltration in patients with noncardiac chest pain. Aliment Pharmacol Ther 2011; 33: 1194–201.
22. Ricker J, McNear S, Cassidy T et al. Routine screening for eosinophilic esophagitis in patients presenting with dysphagia. Therap Adv Gastroenterol 2011; 4: 27–35.
23. Savarino E, Tolone S, Caccaro R et al. Clinical, endoscopic, histological and radiological characteristics of Italian patients with eosinophilic oesophagitis. Dig Liver Dis 2015; 47: 1033–8.
24. Kerlin P, Jones D, Remedios M et al. Prevalence of eosinophilic esophagitis in adults with food bolus obstruction of the esophagus. J Clin Gastroenterol 2007; 41: 356–61.
25. Prasad GA, Alexander JA, Schleck CD et al. Epidemiology of eosinophilic esophagitis over three decades in Olmsted County, Minnesota. Clin Gastroenterol Hepatol 2009; 7: 1055–61.
26. Kapel RC, Miller JK, Torres C et al. Eosinophilic esophagitis: a prevalent disease in the United States that affects all age groups. Gastroenterology 2008; 134: 1316–21.
27. Castro Jimenez A, Gomez Torrijos E, Garcia Rodriguez R et al. Demographic, clinical and allergological characteristics of Eosinophilic Esophagitis in a Spanish central region. Allergol Immunopathol (Madr) 2014; 42: 407–14.
28. van Rhijn BD, Verheij J, Smout AJ et al. Rapidly increasing incidence of eosinophilic esophagitis in a large cohort. Neurogastroenterol Motil 2013; 25: 47–52.
29. González-Cervera J, Arias Á, Redondo-González O et al. The association between atopic manifestations and eosinophilic esophagitis: a systematic review and meta-analysis. Ann Allergy Asth Immunol 2017; 118 (5): 582–90. DOI: 10.1016/j.anai.2017.02.006
30. Remedios M, Campbell C, Jones DM et al. Eosinophilic esophagitis in adults: clinical, endoscopic, histologic findings, and response to treatment with fluticasone propionate. Gastrointest Endosc 2006; 63: 3–12.
31. Croese J, Fairley SK, Masson JW et al. Clinical and endoscopic features of eosinophilic esophagitis in adults. Gastrointest Endosc 2003; 58: 516–22.
32. Spergel JM, Brown-Whitehorn TF, Beausoleil JL et al. 14 years of eosinophilic esophagitis: clinical features and prognosis. J Pediatr Gastroenterol Nutr 2009; 48: 30–6.
33. Saffari H, Peterson KA, Fang JC et al. Patchy eosinophil distributions in an esophagectomy specimen from a patient with eosinophilic esophagitis: Implications for endoscopic biopsy. J Allergy Clin Immunol 2012; 130: 798–800.
34. Nielsen JA, Lager DJ, Lewin M et al. The optimal number of biopsy fragments to establish a morphologic diagnosis of eosinophilic esophagitis. Am J Gastroenterol 2014; 109: 515–20.
35. Salek J, Clayton F, Vinson Let al. Endoscopic appearance and location dictate diagnostic yield of biopsies in eosinophilic oesophagitis. Aliment Pharmacol Ther 2015; 41: 1288–95.
36. Dellon ES, Speck O, Woodward K et al. Distribution and variability of esophageal eosinophilia in patients undergoing upper endoscopy. Mod Pathol 2015; 28: 383–90.
37. Fiocca R, Mastracci L, Engström C et al. Long-term outcome of microscopic esophagitis in chronic GERD patients treated with esomeprazole or laparoscopic antireflux surgery in the LOTUS trial. Am J Gastroenterol 2010; 105: 1015–23.
38. Kim HP, Dellon ES. An Evolving Approach to the Diagnosis of Eosinophilic Esophagitis. Gastroenterol Hepatol (NY) 2018; 14 (6): 358–66.
39. Saffari H, Hoffman LH, Peterson KA et al. Electron microscopy elucidates eosinophil degranulation patterns in patients with eosinophilic esophagitis. J Allergy Clin Immunol 2014; 133: 1728–34.
40. Capocelli KE, Fernando SD, Menard-Katcher C et al. Ultrastructural features of eosinophilic oesophagitis: impact of treatment on desmosomes. J Clin Pathol 2015; 68: 51–6.
41. Collins MH. Histopathologic features of eosinophilic esophagitis and eosinophilic gastrointestinal diseases. Gastroenterol Clin North Am 2014; 43: 257–68.
42. Safroneeva E, Straumann A, Coslovsky M et al. Symptoms have modest accuracy in detecting endoscopic and histologic remission in adults with eosinophilic esophagitis. Gastroenterology 2016; 150: 581–90.
43. Kim HP, Vance RB, Shaheen NJ et al. The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. Clin Gastroenterol Hepatol 2012; 10: 988–96.
44. Liacouras CA, Spergel JM, Ruchelli E et al. Eosinophilic esophagitis: A 10-year experience in 381 children. Clin Gastroenterol Hepatol 2005; 3: 1198–206.
45. Lucendo AJ, Arias A, Molina-Infante J. Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 13–22.
46. Molina-Infante J, Ferrando-Lamana L, Ripoll C et al. Esophageal eosinophilic infiltration responds to proton pump inhibition in most adults. Clin Gastroenterol Hepatol 2011; 9: 110–17.
47. Dellon ES, Liacouras CA. Advances in clinical management of eosinophilic esophagitis. Gastroenterology 2014; 147: 1238–54.
48. Schaefer ET, Fitzgerald JF, Molleston JP et al. Comparison of oral prednisone and topical fluticasone in the treatment of eosinophilic esophagitis: a randomized trial in children. Clin Gastroenterol Hepatol 2008; 6: 165–73.
49. Tan N Di, Xiao YL, Chen MH. Steroids therapy for eosinophilic esophagitis: Systematic review and meta-analysis. J Dig Dis 2015; 16: 431–42.
50. Sawas T, Dhalla S, Sayyar M et al. Systematic review with meta-analysis: pharmacological interventions for eosinophilic oesophagitis. Aliment Pharmacol Ther 2015; 41: 797–806.
51. Murali AR, Gupta A, Attar BM et al. Topical steroids in eosinophilic esophagitis: systematic review and meta-analysis of placebo controlled randomized clinical trials. J Gastroenterol Hepatol 2015; 31: 1111–9.
52. Chuang M-YA, Chinnaratha MA, Hancock DG et al. Topical steroid therapy for the treatment of eosinophilic esophagitis (EoE): a systematic review and meta-analysis. Clin Transl Gastroenterol 2015; 6: e82.
53. Straumann A, Conus S, Degen L et al. Long-term budesonide maintenance treatment is partially effective for patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol 2011; 9: 400–9.
54. Kagalwalla AF, Sentongo TA, Ritz S et al. Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Clin Gastroenterol Hepatol 2006; 4: 1097–102.
55. Henderson CJ, Abonia JP, King EC et al. Comparative dietary therapy effectiveness in remission of pediatric eosinophilic esophagitis. J Allergy Clin Immunol 2012; 129: 1570–8.
56. Wolf WA, Jerath MR, Sperry SLW et al. Dietary elimination therapy is an effective option for adults with eosinophilic esophagitis. Clin Gastroenterol Hepatol 2014; 12: 1272–9.
57. Arias A, Gonzalez-Cervera J, Tenias JM et al. Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis. Gastroenterology 2014; 146: 1639–48.
58. Molina-Infante J, Arias A, Barrio J et al. Four-food group elimination diet for adult eosinophilic esophagitis: A prospective multicenter study. J Allergy Clin Immunol 2014; 134: 1093–99.
59. Molina-Infante J, Modolell I, Alcedo J et al. Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: the 2-4-6 study. United Eur Gastroenterol J 2016; Suppl. 5: A126.
60. Gonsalves N, Yang G-Y, Doerfler B et al. Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors. Gastroenterology 2012; 142: 1451–5.
61. Lucendo AJ, Arias A, Gonzalez-Cervera J et al. Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: a prospective study on the food cause of the disease. J Allergy Clin Immunol 2013; 131: 797–804.
62. Kagalwalla AF, Shah A, Li BUK et al. Identification of specific foods responsible for inflammation in children with eosinophilic esophagitis successfully treated with empiric elimination diet. J Pediatr Gastroenterol Nutr 2011; 53: 145–9.
63. Moawad FJ, Cheatham JG, DeZee KJ. Meta-analysis: the safety and efficacy of dilation in eosinophilic oesophagitis. Aliment Pharmacol Ther 2013; 38: 713–20.
64. Netzer P, Gschossmann JM, Straumann A et al. Corticosteroid-dependent eosinophilic oesophagitis: azathioprine and 6-mercaptopurine can induce and maintain long-term remission. Eur J Gastroenterol Hepatol 2007; 19: 865–9.07; 19: 865–9.