Division of Gastroenterology, Faculty of Medicine, University of Calgary, Teaching Research & Wellness Building, Room 6D48, 3280 Hospital Dr NW, Calgary, AB, Canada T2N4N1.
Br Med Bull. 2011;100:59-72. doi: 10.1093/bmb/ldr045. Epub 2011 Oct 19.
Primary eosinophilic gastrointestinal disorders, a spectrum of inflammatory conditions, occurs when eosinophils selectively infiltrate the gut in the absence of known causes for such tissue eosinophilia. These may be classified into eosinophilic esophagitis, eosinophilic gastroenteritis and eosinophilic colitis (EC). This review focuses on EC: its pathogenesis, epidemiology, clinical presentation, diagnosis and current approach to treatment.
A literature review published in English was performed using Pubmed, Ovid, Google scholar search engines with the following keywords: eosinophilic gastrointestinal disorder, EC, eosinophils, colitis and gastrointestinal.
The basis for primary EC appears related to increased sensitivity to allergens, principally as a food allergy in infants and a T lymphocyte-mediated event in adults. Endoscopic changes are generally modest, featuring edema and patchy granularity.
Clear clinical and pathological diagnostic criteria of EC and its management strategy.
Intestinal involvement of EC is primarily mucosal, presenting as a mild self-limited proctitis in infants and self-limited colitis in young adults. Therapeutic approaches based on case reports tend to use either elimination diets to avoid a presumed allergen; agents traditionally used in inflammatory disease or targeted drugs like anti-histamines or leukotriene receptor antagonists.
Prospective randomized controlled trials addressing the disease natural history, possible preventive methods and effective medical approach and long-term prognosis are required.
原发性嗜酸性粒细胞性胃肠道疾病是一种炎症性疾病谱，当嗜酸性粒细胞在没有已知的组织嗜酸性粒细胞增多原因的情况下选择性浸润肠道时发生。这些疾病可分为嗜酸性食管炎、嗜酸性胃肠炎和嗜酸性结肠炎（EC）。本综述重点介绍 EC：其发病机制、流行病学、临床表现、诊断和当前治疗方法。
使用 Pubmed、Ovid、Google scholar 搜索引擎以英文发表的文献综述，使用以下关键词搜索：嗜酸性粒细胞性胃肠道疾病、EC、嗜酸性粒细胞、结肠炎和胃肠道。
原发性 EC 的基础似乎与对过敏原的敏感性增加有关，主要是婴儿的食物过敏和成人的 T 淋巴细胞介导事件。内镜检查的变化通常较为温和，表现为水肿和斑片状颗粒状。
EC 的明确临床和病理诊断标准及其管理策略。
EC 的肠道受累主要是黏膜，婴儿表现为轻度自限性直肠炎，年轻成人表现为自限性结肠炎。基于病例报告的治疗方法倾向于使用消除饮食来避免假定的过敏原；传统用于炎症性疾病的药物或靶向药物，如抗组胺药或白三烯受体拮抗剂。
需要开展前瞻性随机对照试验，以解决疾病自然史、可能的预防方法、有效治疗方法和长期预后问题。
