John Libbey Eurotext

Médecine thérapeutique / Pédiatrie

MENU

Diagnosis and management of eosinophilic esophagitis: differences between adults and children? Volume 21, issue 1, Janvier-Février-Mars 2018

Figures

  • Figure 1
  • Figure 2
  • Figure 3

Tables

Authors
1 Hospices Civils de Lyon,
Hôpital Femme-Mère-Enfants de Lyon,
service de gastroentérologie,
hépatologie et nutrition pédiatrique,
59 boulevard Pinel,
69677 Bron cedex,
France ; Université Claude Bernard Lyon 1,
Lyon,
France
2 Hospices Civils de Lyon,
Hôpital Lyon-Sud,
service d’hépato-gastroentérologie,
Pierre-Bénite ; Université Claude Bernard Lyon 1,
Lyon,
France,
INSERM U1111,
CIRI,
Lyon,
France
3 Hospices Civils de Lyon,
Hôpital Edouard Herriot,
Lyon,
service d’explorations fonctionnelles digestives ; Université Claude Bernard Lyon 1,
Lyon,
France
* Tirés à part
  • Key words: eosinophilic esophagitis, children, adults, review
  • DOI : 10.1684/mtp.2018.0670
  • Page(s) : 27-35
  • Published in: 2018

Eosinophilic esophagitis (EeO) is related to a chronic and intense eosinophilic esophageal mucosal infiltration (> 15 eosinophils/high power field). It is caused by food allergens, although other factors may also be responsible for. This is a rare disease that should be considered in children and young adult patients, more often in males (75%) with a history of allergic symptoms. EoE should always make part of the differential diagnosis of food impaction or dysphagia. However, its clinical spectrum is wide and includes gastro-oesophageal reflux disease resistant to acid suppression therapy. Only histopathologic examination of oesophageal biopsies may confirm the diagnosis. Digestive diseases associated with eosinophilic infiltration should be excluded (coeliac disease, Crohn's disease, eosinophilic gastroenteritis). Management involves exclusion diet of the offending food allergen and pharmacotherapy (proton pump inhibitors and topical steroids), and in case of strictures may also necessitate endoscopic procedures.