Eosinophilic esophagitis: treatment in 2005
Eosinophilic esophagitis: treatment in 2005
复制标题
DOI：
10.1097/01.mog.0000203863.40632.ba
复制
发表时间：
2006-03-01
影响因子：
2.5
通讯作者：
Liacouras, CA
中科院分区：
文献类型：
--
作者：
Liacouras, CA
回顾的目的嗜酸性食管炎是一种孤立的，嗜酸性的食管炎。这些症状经常被混淆为胃食道反流的症状。在过去的几年里，关于嗜酸性食管炎的文献有了显著的增加，因为超过三分之二的关于这个主题的文章是在过去3年内发表的。由于发病率正在上升，而且通过内窥镜和活检很容易诊断出这种情况，因此了解患者的病理生理、临床表现和治疗方案是很重要的。最近的研究发现，儿童嗜酸性食管炎的病因被报道与对食物抗原的过敏反应有关。由于过敏测试通常无法确定致病食物，因此通常需要完全杜绝所有食物。诊断需要对食道、胃和十二指肠进行活检。如果患者的食道活检显示，尽管使用了侵略性的酸阻滞剂，但每个高倍场有超过20个嗜酸性粒细胞，胃窦和十二指肠的活组织检查是正常的，当从饮食中去除饮食抗原时，组织炎症就会消失，就可以诊断为这种情况。虽然最常见的导致嗜酸性食管炎的食物包括牛奶、鸡蛋、坚果、牛肉、小麦、鱼、贝类、玉米和大豆，但几乎所有食物都与此有关。可供选择的治疗方法包括食道扩张和药物治疗。本文回顾了过去一年的文献，主要集中在儿童和成人嗜酸性食管炎的病理生理和治疗方面。
Purpose of review Eosinophilic esophagitis is an isolated, eosinophilic inflammation of the esophagus. The symptoms are often confused for those of gastroesophageal reflux. Over the past few years, there has been a significant increase in the literature surrounding eosinophilic esophagitis as more than two-thirds of the articles written on the subject have been published within the past 3 years. Because the incidence is rising and the condition is easily diagnosed by endoscopy with biopsy, it is important for physicians to understand the pathophysiology, clinical presentation, and treatment options available for patients.Recent findings The etiology of eosinophilic esophagitis in children is reported to be associated with an allergic response to food antigens. Because allergy tests are often unable to determine the causative foods, complete elimination of all foods is often required. The diagnosis requires a biopsy of the esophagus, stomach and duodenum. The condition is diagnosed if the patient's esophageal biopsy depicts over 20 eosinophils per high-powered field despite the use of aggressive acid blockade, biopsies of the stomach antrum and duodenum are normal, and the tissue inflammation resolves when dietary antigens are removed from the diet. While the most commonly involved foods causing eosinophilic esophagitis include milk, eggs, nuts, beef, wheat, fish, shellfish, corn and soy, almost all foods have been implicated. Alternative treatments include esophageal dilatation and medical therapy.Summary This article reviews the past year's literature, concentrating on the pathophysiology, and treatment of eosinophilic esophagitis in both children and adults.