如何诊治成年无症状性食管嗜酸性粒细胞增多症患者。
How to approach adult patients with asymptomatic esophageal eosinophilia.
作者信息
Schreiner Philipp, Biedermann Luc, Greuter Thomas, Wright Benjamin L, Straumann Alex
机构信息
Department of Gastroenterology & Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Division of Allergy, Asthma, and Clinical Immunology, Department of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.
出版信息
Dis Esophagus. 2021 Jan 11;34(1). doi: 10.1093/dote/doaa105.
Abstract
As the awareness among gastroenterologists regarding endoscopic features suggesting eosinophilic esophagitis is increasing, individuals without symptoms of esophageal dysfunction are increasingly being found to have esophageal eosinophilia on biopsies performed during upper gastrointestinal endoscopies. However, the course of disease and the management of these asymptomatic individuals with esophageal eosinophilia remain elusive. In this review, we propose a definition of asymptomatic individuals with esophageal eosinophilia and discuss the prevalence, risk factors, and course of disease of this specific patient group. Furthermore, we have established a diagnostic and therapeutic pathway based on the most recent available data.
摘要
随着胃肠病学家对提示嗜酸性食管炎的内镜特征的认识不断提高，在上消化道内镜检查时进行活检发现，越来越多没有食管功能障碍症状的个体存在食管嗜酸性粒细胞增多。然而，这些无症状食管嗜酸性粒细胞增多个体的疾病进程和管理方法仍不明确。在本综述中，我们提出了无症状食管嗜酸性粒细胞增多个体的定义，并讨论了这一特定患者群体的患病率、危险因素和疾病进程。此外，我们根据最新可得数据建立了诊断和治疗路径。
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本文引用的文献
1
Food-induced immediate response of the esophagus-A newly identified syndrome in patients with eosinophilic esophagitis.
Allergy. 2021 Jan;76(1):339-347. doi: 10.1111/all.14495. Epub 2020 Aug 19.
2
Risk of progression to eosinophilic esophagitis in patients with asymptomatic esophageal eosinophilia: A retrospective pilot study.
JGH Open. 2019 Oct 11;4(3):422-428. doi: 10.1002/jgh3.12270. eCollection 2020 Jun.
3
Epithelial barriers in allergy and asthma.
J Allergy Clin Immunol. 2020 Jun;145(6):1499-1509. doi: 10.1016/j.jaci.2020.04.010.
4
Gastrointestinal Eosinophil Responses in a Longitudinal, Randomized Trial of Peanut Oral Immunotherapy.
Clin Gastroenterol Hepatol. 2021 Jun;19(6):1151-1159.e14. doi: 10.1016/j.cgh.2020.05.019. Epub 2020 May 17.
5
Tight junctions in the development of asthma, chronic rhinosinusitis, atopic dermatitis, eosinophilic esophagitis, and inflammatory bowel diseases.
J Leukoc Biol. 2020 May;107(5):749-762. doi: 10.1002/JLB.5MR0120-230R. Epub 2020 Feb 28.
6
Approaches and Challenges to Management of Pediatric and Adult Patients With Eosinophilic Esophagitis.
Gastroenterology. 2020 Mar;158(4):840-851. doi: 10.1053/j.gastro.2019.09.052. Epub 2019 Dec 10.
7
EoE disease monitoring: Where we are and where we are going.
Ann Allergy Asthma Immunol. 2020 Mar;124(3):240-247. doi: 10.1016/j.anai.2019.12.004. Epub 2019 Dec 9.
8
Sustained outcomes in oral immunotherapy for peanut allergy (POISED study): a large, randomised, double-blind, placebo-controlled, phase 2 study.
Lancet. 2019 Oct 19;394(10207):1437-1449. doi: 10.1016/S0140-6736(19)31793-3. Epub 2019 Sep 12.
9
Risk Factors and Treatment Outcomes for Oral Immunotherapy-Induced Gastrointestinal Symptoms and Eosinophilic Responses (OITIGER).
J Allergy Clin Immunol Pract. 2020 Jan;8(1):125-131. doi: 10.1016/j.jaip.2019.07.034. Epub 2019 Aug 2.
10
Minimally symptomatic patients with eosinophilic esophagitis should still be actively treated-CON.
Ann Allergy Asthma Immunol. 2019 Jun;122(6):574-575. doi: 10.1016/j.anai.2018.11.020.
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