Eosinophilic Esophagitis Masquerading as Steakhouse Syndrome: A Case Report

Medical Reports, Journal Year: 2025, Volume and Issue: unknown, P. 100176 - 100176

Published: Feb. 1, 2025

Language: Английский

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Diagnosis, management and therapeutic options for eosinophilic esophagitis

Current Opinion in Allergy and Clinical Immunology, Journal Year: 2024, Volume and Issue: 24(3), P. 122 - 128

Published: April 24, 2024

Purpose of review Eosinophilic esophagitis is a chronic and commonly evolving condition leading to relevant potentially irreversible burden in terms tissue damage related functional impairment, thus significantly impacting on quality life. The aim the present summarize recent advances diagnostic work-up pharmacological nonpharmacological management disease, under broader perspective type 2 inflammation. Recent findings Two major novelties have prompted an innovative approach EoE. In diagnosis, it has been proposed dissect disease heterogeneity three endotypes, independent from eosinophil number: EoEe1, characterized by normal appearing oesophagus; EoEe2, associated with inflammation steroid-refractoriness; EoEe3, whose features include adult onset, more fibro-stenotic aspect loss epithelial gene expression. Concerning treatment, two recently licensed drugs for EoE, oro-dispersible budesonide dupilumab represent first treatment options specifically developed EoE addressing EoE-related peculiar pathobiological features. Summary era precision medicine, managing according phenotype-driven might be helpful defining best different forms or stages. addition, exploring coexistence previous occurrence other conditions may suggest opportunity target through biologic therapy. complex pathobiology combining inflammatory features, both at organ systemic level, requires multidimensional relying strict integration gastroenterologists allergist-immunologists.

Language: Английский

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Mononuclear cell composition and activation in blood and mucosal tissue of eosinophilic esophagitis

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: Jan. 22, 2024

Eosinophilic esophagitis (EoE) is a chronic, inflammatory, antigen-driven disease of the esophagus. Tissue EoE pathology has previously been extensively characterized by novel transcriptomics and proteomic platforms, however majority surface marker determination screening performed in blood due to mucosal tissue size limitations. While eosinophils, CD4+ T cells, mast cells natural killer (NK) were investigated context EoE, an accurate picture composition peripheral mononuclear (PBMC) their activation missing. In this study, we aimed comprehensively analyze using measurements with multicolor flow cytometry simultaneously both patients active inactive gastroesophageal reflux (GERD) controls. Moreover, set out validate our data co-cultures PBMC human primary esophageal epithelial inducible mouse model eosinophilic esophagitis, extensive IL-33 secretion Our results indicate that specific populations are enriched, they alter expression markers EoE. particular, observed upregulation immunomodulatory molecule CD38 on myeloid biopsies significant PD-1 which was even more prominent after corticosteroid treatment. With co-culture experiments could demonstrate direct cell contact needed for cells. Finally, validated findings Herein show alterations profile comparison GERD controls, have potential implications To knowledge, study first its kind expanding multi-color approach different patient groups vitro vivo translational models.

Language: Английский

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Eosinophilic Gastrointestinal Disease

JAMA, Journal Year: 2024, Volume and Issue: 331(16), P. 1407 - 1407

Published: March 25, 2024

This JAMA Insights Clinical Update discusses the symptoms, diagnosis, and management of eosinophilic gastrointestinal diseases.

Language: Английский

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Minimally Invasive Approaches to Diagnose and Monitor Eosinophilic GI Diseases

Current Allergy and Asthma Reports, Journal Year: 2024, Volume and Issue: 24(5), P. 269 - 279

Published: March 27, 2024

Language: Английский

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Circulating immunome fingerprint in eosinophilic esophagitis is associated with clinical response to proton pump inhibitor treatment

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: April 5, 2024

Objectives The aim of the study was to characterize circulating immunome patients with EoE before and after proton pump inhibitor (PPI) treatment in order identify potential non-invasive biomarkers response. Methods PBMCs from 19 healthy controls 24 were studied using a 39-plex spectral cytometry panel. plasmacytoid dendritic cell (pDC) population differentially characterized by analysis immunofluorescence assays esophageal biopsies 7 13 patients. Results Interestingly, at baseline had lower levels pDC compared controls. Before treatment, who responded PPI therapy higher classical monocytes, non-responders. Moreover, following increased all patients, while normal only restored PPI-responding Finally, inversely correlated peak eosinophil count biopsies. number tissue pDCs significantly during active EoE, being even non-responder when responder pre-PPI. decreased intake, further almost control post-PPI. Conclusions We hereby describe unique immune fingerprint diagnosis. may be also used as novel biomarker predict subsequent response treatment.

Language: Английский

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Satisfaction With and Adherence to Off-Label Corticosteroids in Adolescents and Adults With Eosinophilic Esophagitis

Journal of Clinical Gastroenterology, Journal Year: 2024, Volume and Issue: unknown

Published: May 15, 2024

Goals: We assessed satisfaction with and adherence to off-label corticosteroids in patients eosinophilic esophagitis (EoE) the United States. Background: EoE is a chronic inflammatory disease for which there are currently no US Food Drug Administration-approved swallowed topical corticosteroids. Study: This noninterventional, cross-sectional, web-based survey included caregivers of adolescents (aged 11 17 y) adults 18 years or older) self-reported [or caregiver-reported (adolescents)] physician diagnosis who were receiving Participants recruited through 2 nonprofit, patient advocacy groups. The 9-item Treatment Satisfaction Questionnaire Medication (TSQM-9) was used assess across effectiveness, convenience, global domains (scale: 1 100 per domain); higher scores indicated greater satisfaction. 4-item Morisky Green Levine Adherence Scale (MGL-4) adherence; an MGL-4 score <3 adherence. also reported reasons nonadherence. Results: Overall, 201 participants (caregivers adolescents, n=98; adults, n=103) this study. Mean TSQM-9 low all 3 (≤61.1) (≤55.7). Slightly fewer (37.1%) than (40.8%) considered adherent. Forgetfulness most frequently reason nonadherence; some chose not take their medications, owing poor palatability (adolescents), difficulty taking medications at specific times (adults), feeling depressed/overwhelmed (adolescents adults). Conclusions:

Language: Английский

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Standardizing visual display of gastrointestinal pathology results for improved clinical interpretation

Journal of Pediatric Gastroenterology and Nutrition, Journal Year: 2024, Volume and Issue: 79(3), P. 550 - 557

Published: Aug. 1, 2024

Pathology is an essential component of disease diagnosis and management in pediatric gastroenterology. reports have not been standardized some areas gastrointestinal pathology reporting varies. Development electronic medical record (EMR) synoptic report templates (PSRT) enables data collection a specific format can help standardize reporting. We developed, implemented, evaluated EMR PSRTs for eosinophilic esophagitis (EoE) inflammatory bowel (IBD).

Language: Английский

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Da etiopatogênese as estratégias terapêuticas: uma revisão integrativa da literatura sobre a esofagite eosinofílica

Revista JRG de Estudos Acadêmicos, Journal Year: 2024, Volume and Issue: 7(14), P. e141190 - e141190

Published: June 7, 2024

Uma condição recentemente identificada que incorpora este conceito é a Esofagite Eosinofílica (EE). Esta afecção caracterizada por inflamação de longa duração do esôfago, marcada um grande número eosinófilos na mucosa proximal e distal. Isto pode ou não ser acompanhado refluxo gastroesofágico. Desta forma, seguinte pesquisa tem objetivo compreender sintetizar informações desde os aspectos etiológicos até as estratégias terapêuticas, proporcionando uma visão holística atualizada dessa médica. Trata-se revisão integrativa, resultou em 12 artigos para análise desta revisão. Os resultados apontam que, indivíduos com predisposição genética podem apresentar infiltração da esofágica componentes granulocíticos, especificamente basófilos, como resultado consumo certos alimentos leite trigo. Um dos benefícios das dietas opção terapêutica elas eliminam necessidade depender medicamentos crônicos controlar doença. IBPs são escolha eficaz o tratamento farmacológico EE, quer sejam utilizados isoladamente combinação outras terapias. Consequentemente, crucial enfatizar importância realização mais pesquisas, incluindo ensaios clínicos randomizados, determinar eficazes podem, última análise, melhorar sintomas bem-estar nutricional pacientes.

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Phenotype of eosinophilic esophagitis with outcome in stenosis in children: a series of clinical cases

Russian Pediatric Journal, Journal Year: 2024, Volume and Issue: 27(3), P. 218 - 227

Published: July 12, 2024

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease characterized by esophageal dysfunction due to prolonged eosinophilic infiltration of tissues. In recent years, there has been tendency increase the prevalence EoE, which may lead an in detection strictures children. Aim: determine clinical features phenotype with outcome stenosis Materials and methods. Seventy children diagnosed EoE were examined, 9 (12.86%) them had stenosis. The average age manifestation was 6.17 years. analysis series cases carried out describe disease. At same time, characteristics patients data from laboratory instrumental examination methods, including esophagogastroduodenoscopy biopsy, used. Results. examined patients, delay diagnosis averaged 3 years after appearance first symptoms. Early manifestations EOE are discomfort when swallowing need grind food. most common concomitant gastroenterological gastroesophageal reflux (GER). All food allergies, 55 (77.8%) allergic cow’s milk proteins (ACMP). Esophageal more often local, lower or middle third. Inflammatory changes mucous membrane (MM) esophagus detected all patients; ring-type disorders noted 47 (66.7%) patients. median maximum number eosinophils MM 30 per 0.3 mm2. Subepithelial fibrosis observed 16 (22.2%) 62 (88.9%) stopped against background conservative treatment. Conclusion. Increasing awareness necessary reduce time for diagnosis, timely treatment risk complications form

Language: Английский

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