Awadhi Sameer Al, Miqdady Mohamad, Abuzakouk Mohamed, Yousef Osama, Tzivinikos Christos, Georgopoulos Filippos, Carr Stuart, Sultan Ahmed, Bitar Rana, Dajani Asad Izziddin, Taha Mazen, Alakrad Eyad, Jazzar Ahmad, Banama Mohammed, Bamakhrama Khaled, Alnahdi Nawal, Elghoudi Ahmed Ali, Azaz Amer, Gutta Ravi, Fahmy Monica, Raghib Boushra, Murad Suzan, Abdelmallek Mina
Gastroenterology, Hepatology, and Endoscopy, Rashid Hospital, Dubai, ARE.
Pediatric Gastroenterology, Hepatology, and Nutrition, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, ARE.
Cureus. 2024 Mar 12;16(3):e56062. doi: 10.7759/cureus.56062. eCollection 2024 Mar.
Eosinophilic esophagitis (EoE) is a chronic, progressive, type 2 inflammatory esophageal disease presenting as dysphagia to solid food and non-obstructive food impaction. Knowledge gaps exist in its diagnosis and management. These expert recommendations focused on the diagnosis of EoE in the United Arab Emirates. An electronic search of PubMed and Embase databases was used to gather evidence from systematic reviews, randomized controlled trials, consensus papers, and expert opinions from the last five years on the diagnosis of EoE. The evidence was graded using the Oxford system. Literature search findings were shared with the expert panel. A 5-point scale (strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree) was used, and a concordance rate of >75% among experts indicated agreement. Using a modified Delphi technique, 18 qualified experts provided 17 recommendations. Eleven statements achieved high agreement, four got moderate agreement, and two got low agreement. Challenges exist in diagnosing EoE, particularly in children. Esophageal biopsies were crucial in diagnosis, irrespective of visible mucosal changes. Further research on diagnostic tools like endoscopic mucosal impedance and biomarkers is needed. Diagnosis relies on esophageal biopsies and symptom-histology correlation; however, tools like EoE assessment questionnaires and endoscopic mucosal impedance could enhance the accuracy and efficiency of EoE diagnosis. The diagnosis of EoE is challenging since the symptoms seldom correlate with the histological findings. Currently, diagnosis is based on patient symptoms and endoscopic and histological findings. Further research into mucosal impedance tests and the role of biomarkers is needed to facilitate diagnosis.
嗜酸性食管炎(EoE)是一种慢性、进行性的2型炎症性食管疾病,表现为固体食物吞咽困难和非阻塞性食物嵌塞。其诊断和管理方面存在知识空白。这些专家建议聚焦于阿拉伯联合酋长国EoE的诊断。通过对PubMed和Embase数据库进行电子检索,以收集过去五年中关于EoE诊断的系统评价、随机对照试验、共识文件和专家意见中的证据。证据采用牛津系统进行分级。文献检索结果与专家小组进行了共享。使用了5分制(强烈同意、同意、既不同意也不反对、不同意、强烈反对),专家之间的一致率>75%表示达成共识。采用改良的德尔菲技术,18名合格专家提出了17条建议。11条陈述达成了高度共识,4条达成了中度共识,2条达成了低度共识。EoE的诊断存在挑战,尤其是在儿童中。无论黏膜是否有可见变化,食管活检在诊断中都至关重要。需要对内窥镜黏膜阻抗和生物标志物等诊断工具进行进一步研究。诊断依赖于食管活检以及症状与组织学的相关性;然而,像EoE评估问卷和内镜黏膜阻抗这样的工具可以提高EoE诊断的准确性和效率。EoE的诊断具有挑战性,因为症状很少与组织学结果相关。目前,诊断基于患者症状以及内镜和组织学检查结果。需要进一步研究黏膜阻抗测试和生物标志物的作用以促进诊断。
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