Guz-Mark Anat, Zevit Noam, Rosenbach Yoram, Morgenstern Sara, Reznik Dana, Davidson Keren, Shamir Raanan, Livni Gilat
Harefuah. 2011 May;150(5):432-7, 492.
Eosinophilic esophagitis (EoE) is an inflammatory disorder with increasing prevalence. It typically presents with swallowing difficulties, heartburn or dyspepsia, and in toddlers, failure to thrive. EoE is characterized by eosinophilic infiltrates of the esophageal mucosa, and endoscopies with tissue diagnosis are mandatory. Hypersensitivity has been implicated in the pathogenesis, therefore, most treatment options include steroids and allergen avoidance.
To summarize a tertiary pediatric clinic's experience with EoE in children and adolescents, describe the spectrum of clinical presentations and treatment options, and raise awareness of this disorder among medical personnel.
A retrospective, descriptive study of patients diagnosed with EoE at our institute over the past 5 years. Demographic details, presenting symptoms, laboratory studies, endoscopic and pathologic findings were analyzed. Information regarding medical and nutritional therapies and response to treatment were summarized.
Fifteen cases of EoE in children and adolescents are described. Average age at diagnosis was 9 years (range 0.7-161. The most common complaint was dysphagia (60%e. The majority demonstrated food allergies 19/121. Most of the patients were treated with topical ingested steroids, while others had either elemental formula or allergen elimination. Favorable responses were seen in most patients treated with steroids (8/11). Long-term results of nutritional therapy are insufficient to draw conclusions on its efficacy.
EoE causes major eating difficulties and affects quality of life in children, sometimes accompanied by failure to thrive. There is a clear association with food allergies, and positive responses to steroids are common. A high index of suspicion and referral to a gastroenterologist for definite diagnosis are required. Combining medical with nutritional treatment seems promising but further studies regarding the long-term outcome are needed.
嗜酸性粒细胞性食管炎（EoE）是一种患病率不断上升的炎症性疾病。其典型症状包括吞咽困难、烧心或消化不良，在幼儿中则表现为发育不良。EoE的特征是食管黏膜有嗜酸性粒细胞浸润，必须通过内镜检查及组织诊断来确诊。超敏反应被认为与发病机制有关，因此，大多数治疗方案包括使用类固醇和避免接触过敏原。
总结一家三级儿科诊所对儿童和青少年EoE的诊治经验，描述临床表现和治疗方案的范围，并提高医务人员对这种疾病的认识。
对我院过去5年诊断为EoE的患者进行回顾性描述性研究。分析人口统计学细节、临床表现、实验室检查、内镜和病理检查结果。总结有关药物和营养治疗以及治疗反应的信息。
描述了15例儿童和青少年EoE病例。诊断时的平均年龄为9岁（范围0.7 - 16岁）。最常见的症状是吞咽困难（60%）。大多数患者表现出食物过敏（19/21）。大多数患者接受了局部摄入类固醇治疗，其他患者则采用要素配方奶粉或避免接触过敏原的方法。大多数接受类固醇治疗的患者（8/11）有良好反应。营养治疗的长期效果尚不足以得出其疗效的结论。
EoE导致儿童出现严重的进食困难并影响生活质量，有时还伴有发育不良。与食物过敏有明显关联，对类固醇治疗有积极反应很常见。需要高度怀疑并转诊至胃肠病专家进行明确诊断。药物治疗与营养治疗相结合似乎很有前景，但需要进一步研究其长期疗效。
