Problemi non correnti
L'esofagite eosinofila
EOSINOPHILIC ESOPHAGITIS IN CHILDREN
JENNY BUA, FEDERICO MARCHETTI, ISABELLA GIUSEPPIN, MIRIS MARANI*, VINCENZO VILLANACCI**, EGIDIO BARBI, STEFANO MARTELOSSI, ALESSANDRO VENTURA
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Università di Trieste
*Dipartimento di Pediatria, Ospedale Bufalini, Cesena
**Servizio di Anatomia Patologica, Ospedale dei Bambini, Brescia
Ottobre 2007 - pagg. 500 -508
Abstract
Eosinophilic esophagitis (EE) is the leading cause of dysphagia in children. Long underestimated
in the past, it is nowadays reported with increasing frequency both in paediatric and
adult gastroenterology. However, its natural history, its pathogenesis and most efficacious therapy
are far from being clear. The Authors review EE clinical presentation in children, how to
diagnose it and what is the evidence supporting its available treatment options. They also report
their clinical experience of 8 new EE cases diagnosed during a 3 year-period.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Landres RT, Kuster GG, Strum WB. Eosinophilic
esophagitis in a patient with vigorous
achalasia. Gastroenterology 1978;74:1298-
301.
2. Arora AS, Yamazaki K. Eosinophilic esophagitis: asthma of the esophagus? Clin Gastroenterol Hepatol 2004;2:523-30.
3. Rothenberg ME. Eosinophilic gastrointestinal disorders. J Allergy Clin Immunol 2004; 113:11-28.
4. Rothenberg ME, Mishra A, Brandt EB, et al. Gastrointestinal eosinophils. Immunol Rev 2001;179:139-55.
5. Yan BM, Shaffer EA. Eosinophilic esophagitis: a newly established cause of dysphagia. World J Gastroenterol 2006;12:2328-34.
6. Cherian S, Smith NM, Forbes DA. Rapidly increasing prevalence of eosinophilic oesophagitis in Western Australia. Arch Dis Child 2006;91:1000-04.
7. Esposito S, Marinello D, Paracchini R, et al. Long term follow-up of symptoms and peripheral eosinophil counts in seven children with eosinophilic esophagitis. J Paediatr Gastroenterol Nutr 2004;38:452-6.
8. Kumar R, Sentongo T, Nelson SP, et al. Eosinophilic esophagitis in children: a review. Clin Applied Immunol Rev 2003;4:173-88.
9. Pentiuk SP, Miller CK, Kaul A. Eosinophilic esophagitis in infants and toddlers. Dysphagia 2007;22:44-8.
10. Orenstein SR, Shalaby TM, Di Lorenzo C, et al. The spectrum of pediatric eosinophilic esophagitis beyond infancy: a clinical series of 30 children. AJG 2000;95(6);1422-30.
11. Sant’Anna AM, Rolland S, Fournet JC, et al. Eosinophilic esophagitis in children: symptoms, histology and pH probe results. J Pediatr Gastroenterol Nutr 2004;39(4):373-7.
12. Noel RJ, Putman PE, Rothenberg ME. Eosinophilic esophagitis. N Engl J Med 2004; 351:940-1.
13. Verzegnassi F, Bua J, De Angelis P, et al. Eosinophilic oesophagitis and coeliac disease: is it just a casual association? Gut 2007; 56(7):1029-30.
14. Quaglietta L, Coccorullo P, Miele E, et al. Eosinophilic oesophagitis and coeliac disease: is there an association? Aliment Pharmacol Ther 2007;26:487-93.
15. Rothemberg ME, Mishra A, Collins MC, Putnam PE. Pathogenesis and clinical features of eosinophilic esophagitis. J Allergy Clin Immunol 2001;108:891-4.
16. Mishra A, Hogan SP, Brandt EB, Rothenberg ME. An etiological role for aeroallergens and eosinophils in experimental esophagitis. J Clin Invest 2001;107:83-90.
17. Straumann A, Bauer M, Fischer B, et al. Idiopathic eosinophilic esophagitis is associated with a Th2-type allergic inflammatory response. J Allergy Clin Immunol 2001;108:954- 61.
18. Dvorak AM, Onderdonk AB, McLeod RS, et al. Ultrastructural identification of exocytosis of granules from human gut eosinophils in vivo. Int Arch Allergy Immunol 1993;102:33- 45.
19. Munitz A, Levi-Schaffer F. Eosinophils: “new” roles for “old” cells. Allergy 2004:59: 268-75.
20. Guajardo JR, Plotnick LM, Fende JM, et al. Eosinophil-associated gastrointestinal disorders: a world-wide-web based registry. J Pediatr 2002;141:576-81.
21. Sundaram S, Sunku B, Nelson SP, et al. Adherent white plaques: an endoscopic finding in eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2004;38:208-12.
22. Riou PJ, Nicholson AG, Pastorino U. Esophageal rupture in a patient with idiopatic eosinophilic esophagitis. Ann Thorac Surg 1996;62(6):1854-6.
23. Khan S, Orestein SR, Di Lorenzo C, et al. Eosinophilic esophagitis: structures, impaction, dysphagia. Dig Dis Sci 2003;48:22-9.
24. Winter HS, Mandara JL, Stafford RJ, et al. Intraepitelial eosinophils: a new diagnostic criterion for reflux esophagitis. Gastroenterology 1982;83:818-23.
25. Walsh SV, Antonioli DA, Goldman H, et al. Allergic esophagitis in children: a clinicopathological entity. Am J Surg Pathol 1999;23: 390-6.
26. Kukurozovich RH, Elliot EJ, O’loughlin EV, Markovitz JE. Non-surgical interventions for eosinophilic oesophagitis. Cochrane Database Syst Rev 2004(3)CD004065.
27. Gupta SK, Fitzgerald JF, Davis MM, et al. Treatment of allergic eosinophilic esophagitis (AEE) with oral prednisone (P) and swallowed fluticasone (F): a randomised, prospective study in children. Gastroenterology 2003; 124(4 suppl):A-19.
28. Konikoff MR, Noel RJ, Blanchard C, et al. A randomized, double-blind, placebo-controlled trial of fluticasone propionate for pediatric eosinophilic esophagitis. Gastroenterology 2006;131:1381-91.
29. Spergel JM, Beausoleil JL, Mascarenhas M, Liacouras CA. The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis. J Allergy Clin Immunol 2002;141:576-81.
30. Kelly KJ, Lazenby AJ, Rowe PC, et al. Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino- acid based formula. Gastroenterology 1995;109:1503-12.
31. Markowitz JE, Spergel JM, Ruchelli E, Liacouras CA. Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents. Am J Gastroenterol 2003;98: 777-82.
32. De Augustin JC, Sanz N, Canals MJ, et al. Successful medical treatment of two patients with eosinophilic esophagitis. J Pediatr Surg 2002;37:207-13.
33. Teitelbaum JE, Fox VL, Twarog FJ, et al. Eosinophilic esophagitis in children: immunopathological analysis and response to fluticasone propionate. Gastroenterology 2002; 122:1216-25.
34. Faubion WA Jr, Perrault J, Burgart LJ, et al. Treatment of eosinophilic esophagitis with inhaled corticosteroids. J Paediatr Gastroenterol Nutr 1998;27:90-3.
35. Noel RJ, Putnam PE, Collins MH, et al. Clinical and immunopathologic effects of swallowed fluticasone for eosinophilic esophagitis. Clin Gastroenterol Hepatol 2004;2:568-75.
36. Arora AS, Perrault J, Smyrk TC. Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults. Mayo Clin Proc 2003;78:181-5.
37. Ronkainen J, Talley NJ, Aro P, et al. Prevalence of oesophageal eosinophils and eosinophilic oesophagitis in adults: the populationbased Kalixanda study. Gut 2007;56:615-20.
38. Dempsey OJ, Coutie WJ, Wilson AM, Williams P, Lipworth BJ. Evaluation of the buccal component of systemic absorption with inhaled fluticasone propionate. Thorax 1999;54 (7):614-7
39. Aceves SS, Bastian JF, Newbury RO, Dohil R. Oral viscous budesonide: a potential new therapy for eosinophilic esophagitis in children. Am J Gastroenterol 2007 [Epub ahead of print].
40. Liacouras CA, Wenner WJ, Brown K, et al. Primary eosinophilic esophagitis in children: successful treatment with oral corticosteroids. J Paediatr Gastroenterol Nutr 1998;26: 380-5.
41. Attwood SE, Lewis CJ, Bronder CS, et al. Eosinophilic esophagitis: a novel treatment using Montelukast. Gut 2003;52:181-5.
42. Garrett JK, Jameson SC, Thomson B, et al. Anti-interleukin-5 (mepolizumab) therapy for hypereosinophilic syndromes. J Allergy Clin Immunol 2004;113:115-9.
43. Dellon ES, Aderoju A, Woosley JT, Sandler RS, Shaheen NJ. Variability in diagnostic criteria for eosinophilic esophagitis: a systematic review. Am J Gastroenterol 2007 [Epub ahead of print].
2. Arora AS, Yamazaki K. Eosinophilic esophagitis: asthma of the esophagus? Clin Gastroenterol Hepatol 2004;2:523-30.
3. Rothenberg ME. Eosinophilic gastrointestinal disorders. J Allergy Clin Immunol 2004; 113:11-28.
4. Rothenberg ME, Mishra A, Brandt EB, et al. Gastrointestinal eosinophils. Immunol Rev 2001;179:139-55.
5. Yan BM, Shaffer EA. Eosinophilic esophagitis: a newly established cause of dysphagia. World J Gastroenterol 2006;12:2328-34.
6. Cherian S, Smith NM, Forbes DA. Rapidly increasing prevalence of eosinophilic oesophagitis in Western Australia. Arch Dis Child 2006;91:1000-04.
7. Esposito S, Marinello D, Paracchini R, et al. Long term follow-up of symptoms and peripheral eosinophil counts in seven children with eosinophilic esophagitis. J Paediatr Gastroenterol Nutr 2004;38:452-6.
8. Kumar R, Sentongo T, Nelson SP, et al. Eosinophilic esophagitis in children: a review. Clin Applied Immunol Rev 2003;4:173-88.
9. Pentiuk SP, Miller CK, Kaul A. Eosinophilic esophagitis in infants and toddlers. Dysphagia 2007;22:44-8.
10. Orenstein SR, Shalaby TM, Di Lorenzo C, et al. The spectrum of pediatric eosinophilic esophagitis beyond infancy: a clinical series of 30 children. AJG 2000;95(6);1422-30.
11. Sant’Anna AM, Rolland S, Fournet JC, et al. Eosinophilic esophagitis in children: symptoms, histology and pH probe results. J Pediatr Gastroenterol Nutr 2004;39(4):373-7.
12. Noel RJ, Putman PE, Rothenberg ME. Eosinophilic esophagitis. N Engl J Med 2004; 351:940-1.
13. Verzegnassi F, Bua J, De Angelis P, et al. Eosinophilic oesophagitis and coeliac disease: is it just a casual association? Gut 2007; 56(7):1029-30.
14. Quaglietta L, Coccorullo P, Miele E, et al. Eosinophilic oesophagitis and coeliac disease: is there an association? Aliment Pharmacol Ther 2007;26:487-93.
15. Rothemberg ME, Mishra A, Collins MC, Putnam PE. Pathogenesis and clinical features of eosinophilic esophagitis. J Allergy Clin Immunol 2001;108:891-4.
16. Mishra A, Hogan SP, Brandt EB, Rothenberg ME. An etiological role for aeroallergens and eosinophils in experimental esophagitis. J Clin Invest 2001;107:83-90.
17. Straumann A, Bauer M, Fischer B, et al. Idiopathic eosinophilic esophagitis is associated with a Th2-type allergic inflammatory response. J Allergy Clin Immunol 2001;108:954- 61.
18. Dvorak AM, Onderdonk AB, McLeod RS, et al. Ultrastructural identification of exocytosis of granules from human gut eosinophils in vivo. Int Arch Allergy Immunol 1993;102:33- 45.
19. Munitz A, Levi-Schaffer F. Eosinophils: “new” roles for “old” cells. Allergy 2004:59: 268-75.
20. Guajardo JR, Plotnick LM, Fende JM, et al. Eosinophil-associated gastrointestinal disorders: a world-wide-web based registry. J Pediatr 2002;141:576-81.
21. Sundaram S, Sunku B, Nelson SP, et al. Adherent white plaques: an endoscopic finding in eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2004;38:208-12.
22. Riou PJ, Nicholson AG, Pastorino U. Esophageal rupture in a patient with idiopatic eosinophilic esophagitis. Ann Thorac Surg 1996;62(6):1854-6.
23. Khan S, Orestein SR, Di Lorenzo C, et al. Eosinophilic esophagitis: structures, impaction, dysphagia. Dig Dis Sci 2003;48:22-9.
24. Winter HS, Mandara JL, Stafford RJ, et al. Intraepitelial eosinophils: a new diagnostic criterion for reflux esophagitis. Gastroenterology 1982;83:818-23.
25. Walsh SV, Antonioli DA, Goldman H, et al. Allergic esophagitis in children: a clinicopathological entity. Am J Surg Pathol 1999;23: 390-6.
26. Kukurozovich RH, Elliot EJ, O’loughlin EV, Markovitz JE. Non-surgical interventions for eosinophilic oesophagitis. Cochrane Database Syst Rev 2004(3)CD004065.
27. Gupta SK, Fitzgerald JF, Davis MM, et al. Treatment of allergic eosinophilic esophagitis (AEE) with oral prednisone (P) and swallowed fluticasone (F): a randomised, prospective study in children. Gastroenterology 2003; 124(4 suppl):A-19.
28. Konikoff MR, Noel RJ, Blanchard C, et al. A randomized, double-blind, placebo-controlled trial of fluticasone propionate for pediatric eosinophilic esophagitis. Gastroenterology 2006;131:1381-91.
29. Spergel JM, Beausoleil JL, Mascarenhas M, Liacouras CA. The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis. J Allergy Clin Immunol 2002;141:576-81.
30. Kelly KJ, Lazenby AJ, Rowe PC, et al. Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino- acid based formula. Gastroenterology 1995;109:1503-12.
31. Markowitz JE, Spergel JM, Ruchelli E, Liacouras CA. Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents. Am J Gastroenterol 2003;98: 777-82.
32. De Augustin JC, Sanz N, Canals MJ, et al. Successful medical treatment of two patients with eosinophilic esophagitis. J Pediatr Surg 2002;37:207-13.
33. Teitelbaum JE, Fox VL, Twarog FJ, et al. Eosinophilic esophagitis in children: immunopathological analysis and response to fluticasone propionate. Gastroenterology 2002; 122:1216-25.
34. Faubion WA Jr, Perrault J, Burgart LJ, et al. Treatment of eosinophilic esophagitis with inhaled corticosteroids. J Paediatr Gastroenterol Nutr 1998;27:90-3.
35. Noel RJ, Putnam PE, Collins MH, et al. Clinical and immunopathologic effects of swallowed fluticasone for eosinophilic esophagitis. Clin Gastroenterol Hepatol 2004;2:568-75.
36. Arora AS, Perrault J, Smyrk TC. Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults. Mayo Clin Proc 2003;78:181-5.
37. Ronkainen J, Talley NJ, Aro P, et al. Prevalence of oesophageal eosinophils and eosinophilic oesophagitis in adults: the populationbased Kalixanda study. Gut 2007;56:615-20.
38. Dempsey OJ, Coutie WJ, Wilson AM, Williams P, Lipworth BJ. Evaluation of the buccal component of systemic absorption with inhaled fluticasone propionate. Thorax 1999;54 (7):614-7
39. Aceves SS, Bastian JF, Newbury RO, Dohil R. Oral viscous budesonide: a potential new therapy for eosinophilic esophagitis in children. Am J Gastroenterol 2007 [Epub ahead of print].
40. Liacouras CA, Wenner WJ, Brown K, et al. Primary eosinophilic esophagitis in children: successful treatment with oral corticosteroids. J Paediatr Gastroenterol Nutr 1998;26: 380-5.
41. Attwood SE, Lewis CJ, Bronder CS, et al. Eosinophilic esophagitis: a novel treatment using Montelukast. Gut 2003;52:181-5.
42. Garrett JK, Jameson SC, Thomson B, et al. Anti-interleukin-5 (mepolizumab) therapy for hypereosinophilic syndromes. J Allergy Clin Immunol 2004;113:115-9.
43. Dellon ES, Aderoju A, Woosley JT, Sandler RS, Shaheen NJ. Variability in diagnostic criteria for eosinophilic esophagitis: a systematic review. Am J Gastroenterol 2007 [Epub ahead of print].
Corrispondenza: jennybua@gmail.com