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耳鼻喉科医生眼中的嗜酸性食管炎

Eosinophilic esophagitis for the otolaryngologist.

作者信息

Karkos Petros D, Srivastava R, Kaptanis S, Vaughan C

机构信息

Department of Otolaryngology, Bradford Royal Infirmary, Bradford BD96RJ, UK.

出版信息

Int J Otolaryngol. 2012;2012:181402. doi: 10.1155/2012/181402. Epub 2011 Dec 15.

Abstract

Objectives. This paper focuses on current diagnostic and treatment options for Eosinophilic Esophagitis (EE). Study Design. literature review. Results. EE can be suspected on history and endoscopy although definitive diagnosis is strictly based on histopathology. It is a relatively new entity and is often misdiagnosed as gastroesophageal reflux (GERD). Eosinophilic infiltration of the esophageal mucosa is responsible for esophageal symptoms which can range from mild to debilitating dysphagia and food impaction, when untreated. In fact recurrent foreign body and food impaction can often be blamed for undiagnosed EE. There seems to be a strong familial component and association with allergy. The introduction of transnasal esophagoscopy in adult laryngology has enabled otolaryngologists to readily diagnose EE and promoted awareness of this often difficult to recognize entity. Conclusions. Despite higher awareness, the literature suggests that EE remains a commonly misdiagnosed condition especially in the otolaryngology community. Genetic studies are required to unfold the true familial and genetic component of this fascinating entity.

摘要

目标。本文聚焦于嗜酸性粒细胞性食管炎(EE)的当前诊断和治疗选择。研究设计。文献综述。结果。尽管确诊严格基于组织病理学,但EE可根据病史和内镜检查怀疑。它是一个相对较新的疾病实体,常被误诊为胃食管反流(GERD)。食管黏膜的嗜酸性粒细胞浸润是食管症状的原因,这些症状从轻度到使人衰弱的吞咽困难和食物嵌塞不等,若不治疗。实际上,反复的异物和食物嵌塞常常可归咎于未被诊断的EE。似乎有很强的家族因素以及与过敏的关联。经鼻食管镜检查在成人喉科学中的引入使耳鼻喉科医生能够容易地诊断EE,并提高了对这个常常难以识别的疾病实体的认识。结论。尽管认识有所提高,但文献表明EE仍然是一种常被误诊的疾病,尤其是在耳鼻喉科领域。需要进行基因研究以揭示这个迷人疾病实体真正的家族和遗传因素。

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Eur J Pediatr. 2011 Nov;170(11):1471-4. doi: 10.1007/s00431-011-1540-4. Epub 2011 Aug 2.
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Eosinophilic esophagitis: updated consensus recommendations for children and adults.嗜酸粒细胞性食管炎:儿童和成人的最新共识建议。
J Allergy Clin Immunol. 2011 Jul;128(1):3-20.e6; quiz 21-2. doi: 10.1016/j.jaci.2011.02.040. Epub 2011 Apr 7.
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Eosinophilic oesophagitis: the essentials for daily practice.嗜酸性食管炎:日常实践要点
Scand J Gastroenterol. 2010 May;45(5):528-32. doi: 10.3109/00365521003587788.
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Dilation in eosinophilic esophagitis: to do or not to do?嗜酸性食管炎的扩张治疗:做还是不做?
Gastrointest Endosc. 2010 Apr;71(4):713-4. doi: 10.1016/j.gie.2009.12.026.

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