Section of Pediatric Allergy and Immunology, Department of Pediatrics, Children's Hospital of Colorado, Aurora, Colorado; Gastrointestinal Eosinophilic Disease Program, University of Colorado School of Medicine, Aurora, Colorado.
Gastrointestinal Eosinophilic Disease Program, University of Colorado School of Medicine, Aurora, Colorado; Digestive Health Institute, Department of Pediatrics, Children's Hospital of Colorado, Aurora, Colorado.
Ann Allergy Asthma Immunol. 2018 Aug;121(2):162-167. doi: 10.1016/j.anai.2018.06.013. Epub 2018 Jun 22.
Eosinophilic gastrointestinal diseases (EGIDs) are a rare group of disorders that can have varied clinical presentations dependent on the involved segment within the gastrointestinal tract. Eosinophilic gastritis presents with abdominal pain or vomiting, eosinophilic gastroenteritis presents with diarrhea and anemia or hypoalbuminemia, and eosinophilic colitis can present with diarrhea or bloody stools. These nonspecific symptoms remain poorly understood in their relation to the underlying pathogenesis, but a significant percentage of patients have atopy. In this review, we discuss the current literature on EGIDs to promote a practical approach to diagnosis and care.
Review of published literature.
Clinically relevant literature from 1900 through 2018 was obtained from a PubMed search. Those that addressed prevalence, diagnosis, clinical manifestations, natural history, and treatment of EGIDs were reviewed and are summarized in this article.
Of the 485 articles found in the search, most of which were case reports, 71 were selected for review. The natural history of EGIDs is based primarily on case series and small numbers of patients, making therapeutic decisions difficult. Treatment remains limited to dietary restriction that is not effective in many patients and topical or systemic corticosteroids whose long-term use is to be avoided if possible.
With the seeming increase in all types of EGIDs, phenotypic descriptions are emerging that will likely promote better understanding of the pathogenesis and identification of novel therapeutic targets.
嗜酸性粒细胞性胃肠道疾病（EGIDs）是一组罕见的疾病，其临床表现因胃肠道受累部位而异。嗜酸性粒细胞性胃炎表现为腹痛或呕吐，嗜酸性粒细胞性胃肠炎表现为腹泻和贫血或低白蛋白血症，嗜酸性结肠炎可表现为腹泻或血性粪便。这些非特异性症状与其潜在发病机制的关系仍知之甚少，但相当一部分患者有特应性。在这篇综述中，我们讨论了 EGIDs 的现有文献，以促进对诊断和治疗的实用方法。
对已发表文献的回顾。
通过 PubMed 搜索获得了 1900 年至 2018 年的临床相关文献。对涉及 EGIDs 的患病率、诊断、临床表现、自然史和治疗的文献进行了回顾，并在本文中进行了总结。
在搜索中发现的 485 篇文章中，大多数是病例报告，其中 71 篇被选作综述。EGIDs 的自然史主要基于病例系列和少数患者，这使得治疗决策变得困难。治疗仍然限于饮食限制，但对许多患者无效，并且需要避免长期使用局部或全身皮质类固醇。
随着所有类型的 EGIDs 的似乎增加，正在出现表型描述，这可能有助于更好地理解发病机制和确定新的治疗靶点。
