EOSINOPHILIC ESOPHAGITIS

Abstract

Eosinophilic esophagitis (EE) is increasingly recognized in children and adult. This review summarizes the current knowledge of EE including the epidemiology, pathophysiology, clinical presentation,
diagnostic criteria, treatment, and prognosis. An extensive search of PubMed/Medline (1977-2009) for available English literature for EE was completed. The estimated incidence is 4,3/10 000 in children and 2,5/10000 in adults. The diagnosis of EE is based on the presence of both typical symptoms and pathologic findings on esophageal biopsy. Patients usually present with reflux-like or esophageal dysfunction symptoms, and biopsy of the esophagus shows more than 15 eosinophils per high-power field. There are no standardized protocols for the therapy of EE. A variety of therapeutic approaches including dietary modifications, topical or systemic corticosteroids, immunomodulators and endoscopic dilatation of esophagus can be used alone or in combination. The long-term prognosis of EE is largely unknown. In some infants and young children with food protein-induced EE, the disease may remit due to development of oral tolerance to the offending food protein. However, EE usually follows a chronic relapsing course.