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小儿嗜酸性食管炎:临床医师须知。

Pediatric eosinophilic esophagitis: a review for the clinician.

机构信息

Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.

Predictive and Preventive Medicine Research Unit, Multifactorial and Systemic Diseases Research Area, Pediatric Allergy Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

出版信息

Ital J Pediatr. 2021 Nov 22;47(1):230. doi: 10.1186/s13052-021-01178-2.

Abstract

Eosinophilic esophagitis (EoE) is a chronic clinical-pathologic disease characterized by eosinophilic infiltration of the esophageal epithelium with esophageal dysfunction symptoms.EoE can occur at any age and has different clinical manifestations depending on the age onset.To date, esophago-gastroduodenal endoscopy (EGD) with biopsy is the gold-standard for EoE diagnosis.According to the recent consensus guidelines, proton pump inhibitors, corticosteroids and elimination diets could be a first-line therapy option. The aim of the treatment is clinical and histological remission for preventing long-lasting untreatable fibrosis.A multidisciplinary approach (allergist, gastroenterology, dietitian, and pathologist) is recommended for managing patients affected by EoE, given the complexity of its treatment.This review will provide a practical guide to assist pediatricians treating children with EoE.Moreover, it highlights the unmet needs in diagnosis and treatment that require urgent attention from the scientific community in the aim of improving the management of patients with EoE.

摘要

嗜酸性食管炎(EoE)是一种慢性临床病理疾病,其特征是食管上皮内嗜酸性粒细胞浸润和食管功能障碍症状。EoE 可发生于任何年龄,且因发病年龄不同而有不同的临床表现。迄今为止,食管胃十二指肠镜检查(EGD)联合活检是 EoE 诊断的金标准。根据最近的共识指南,质子泵抑制剂、皮质类固醇和排除饮食可以作为一线治疗选择。治疗的目的是实现临床和组织学缓解,以预防持久的无法治疗的纤维化。鉴于其治疗的复杂性,建议采用多学科方法(过敏专家、胃肠病学家、营养师和病理学家)来管理患有 EoE 的患者。本文将为儿科医生治疗患有 EoE 的儿童提供实用指南,同时强调在诊断和治疗方面存在的未满足需求,这需要引起科学界的迫切关注,以便改善 EoE 患者的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b3e/8609874/76649a7fbaf0/13052_2021_1178_Fig1_HTML.jpg

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