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：
10.1016/s0002-9270(03)00054-6
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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：嗜酸性食管炎(EoE)是一种以食道粘膜嗜酸性粒细胞浸润为特征的疾病，其定义在很大程度上是通过已发表的病例报道和系列报道，导致诊断和治疗方案的模糊性。据报道，皮质类固醇、色甘露和元素饮食都是治疗EoE的成功方法。在这项研究中，我们试图准确地定义EoE患者的群体，然后评估他们对元素饮食的反应。方法：通过食管胃十二指肠镜(EGD)确定一系列具有胃食道反流病慢性症状和孤立的食道嗜酸性粒细胞增多症的患者。使用质子泵抑制剂治疗3个月，当症状持续时重复EGD。进行24小时pH探头检查，排除有显著异常的患者。结果：在346例慢性胃食道反流病患者中，51例(14.7%)最终诊断为EoE。在基本饮食后，呕吐、腹痛和吞咽困难有显著改善。每高倍视野内食道嗜酸性粒细胞中位数(HPF)由饮食前的33.7个降至饮食后的1.0个(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