Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents
Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents
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DOI：
10.1111/j.1572-0241.2003.07390.x
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发表时间：
2003-04-01
影响因子：
9.8
通讯作者：
Liacouras, CA
中科院分区：
文献类型：
--
作者：
Markowitz, JE;Spergel, JM;Liacouras, CA
目的：嗜酸性粒细胞性食管炎（EoE）是一种以食管粘膜嗜酸性粒细胞浸润为特征的疾病，在很大程度上是通过已发表的病例报告和系列来定义的，导致诊断和治疗选择的模糊性。皮质类固醇、克罗埃西亚和元素饮食都被报道为EoE的成功治疗方法。在这项研究中，我们试图准确地定义EoE患者的人口，然后评估他们的反应元素diet.METHODS：一系列患者的慢性症状的胃食管反流病和孤立的食管嗜酸性粒细胞增多症的食管胃镜（EGD）进行了鉴定。质子泵抑制剂治疗3个月，然后重复EGD时，症状持续存在。进行了24小时pH探针研究，并排除了那些有显着异常的研究。其余患者被诊断为EoE，并放置在一个月的元素饮食，然后重复EGD.Results：346例慢性胃食管反流病症状和嗜酸性粒细胞食管活检，51（14.7%）最终被诊断为EoE。基础饮食后，呕吐、腹痛和吞咽困难有显著改善。食管嗜酸性粒细胞/高倍视野（HPF）的中位数从饮食前的33.7下降到饮食后的1.0（p
OBJECTIVE: Eosinophilic esophagitis (EoE), a disorder characterized by eosinophilic infiltration of the esophageal mucosa, has been defined in large part through published case reports and series leading to ambiguity in both diagnostic and treatment options. Corticosteroids, cromolyn, and elemental diet have all been reported as successful treatments for EoE. In this study, we sought to accurately define a population of patients with EoE and then assess their response to elemental diet.METHODS: A series of patients with chronic symptoms of gastroesophageal reflux disease and an isolated esophageal eosinophilia on esophagogastroduodenoscopy (EGD) were identified. Therapy with a proton pump inhibitor was instituted for 3 months, followed by repeat EGD when symptoms persisted. A 24-h pH probe study was performed, and those with significantly abnormal studies were excluded. The remaining patients were diagnosed with EoE and placed on an elemental diet for I month, followed by a repeat EGD.RESULTS: Of 346 patients with chronic gastroesophageal reflux disease symptoms and eosinophils on esophageal biopsy, 51 (14.7%) were ultimately diagnosed with EoE. There was significant improvement in vomiting, abdominal pain, and dysphagia after the elemental diet. The median number of esophageal eosinophils per high-powered field (HPF) decreased from 33.7 before the diet to 1.0 after the diet (p