Eosinophilic esophagitis historical perspective
|
Eosinophilic Esophagitis Microchapters |
|
Differentiating Eosinophilic Esophagitis from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Eosinophilic esophagitis historical perspective On the Web |
|
American Roentgen Ray Society Images of Eosinophilic esophagitis historical perspective |
|
Risk calculators and risk factors for Eosinophilic esophagitis historical perspective |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Ajay Gade MD[2]]
Overview
In 1978, Landres et al reported an isolated case of vigorous achalasia and concluded that this was a variant of eosinophilic gastroenteritis in a patient with marked hypertrophy and eosinophilic infiltration of esophagus. In 1981, Picus and Frank reported a case of a 16-year-old boy with progressive dysphagia for 1.5 years, endoscopic findings were suggestive of multiple 1-mm nodular filling defects in the esophagus in an area of stricture with dilatation above. The radiology showed a luminal narrowing, wall rigidity, and high circulating eosinophil count assumed to be a variant of eosinophilic gastroenteritis. In 1982, Münch et al and in 1983, Matzinger and Daneman both described isolated cases of esophageal eosinophilia with dysphagia in patients with assumed eosinophilic gastroenteritis. In 1985, Feczko et al reported 3 cases of eosinophilic infiltration of esophagus, with 2 of the patients showing eosinophilic gastroenteritis. Two out of the three patients developed esophageal stricture secondary to submucosal fibrosis. In 1985, eosinophilic infiltration was reported in esophageal mucosal biopsy of 11 patients with average age of 14.6 years. These patients had reflux symptoms and their eosinophil density was low. In retrospect, these were probably patients with gastroesophageal reflux disease (GERD). In 1989, Attwood et al described esophageal asthma, an episodic dysphagia with eosinophilic infiltrates. These investigators compared a group of 15 adults who presented with dysphagia without esophageal obstruction and normal pH monitoring to a group of 100 adults with GERD as defined by increased acid exposure in the distal esophagus. In 1993, Attwood et al reported 12 adults with dysphagia, normal pH monitoring, and dense esophageal eosinophilia. Seven patients had food hypersensitivity, and all required advanced intervention (dilatation and/or steroids in 1 case) for resolution of symptoms. In 1994, Straumann et al described a series of 10 patients with acute recurrent dysphagia seen over a 4-year period. These patients showed discrete endoscopic changes, and high concentrations of epithelial esophageal eosinophils. They improved following systemic steroid and antihistamine treatment. In 1995 the first publication in children was reported by Kelly et al. They identified 10 children who were diagnosed on clinical and histological grounds to have EoE. Six out of those ten had been subject to antireflux therapy without any symptomatic improvement. Two of these patients had already received fundoplication, and all responded well to amino acid formulas, suggesting an allergic etiology. The characteristics in pediatric EoE appeared to reflect greater amounts of regurgitation and failure to thrive, while the typical presentation in adults with EoE was dysphagia and food impaction. In 2003 the chronic nature of the natural history of EoE was described by Straumann et after the follow-up of 30 adults with EoE.
Historical Perspective
- The historical perspective of the EoE is as the following:[1][2][3][4][5][6][7][8][9][10]
- In 1978, Landres et al reported an isolated case of vigorous achalasia and concluded that this was a variant of eosinophilic gastroenteritis in a patient with marked hypertrophy and eosinophilic infiltration of esophagus.
- In 1981, Picus and Frank reported a case of a 16-year-old boy with progressive dysphagia for 1.5 years, endoscopic findings were suggestive of multiple 1-mm nodular filling defects in the esophagus in an area of stricture with dilatation above.
- The radiology showed a luminal narrowing, wall rigidity, and high circulating eosinophil count assumed to be a variant of eosinophilic gastroenteritis.
- In 1982, Münch et al and in 1983, Matzinger and Daneman both described isolated cases of esophageal eosinophilia with dysphagia in patients with assumed eosinophilic gastroenteritis.
- In 1985, Feczko et al reported 3 cases of eosinophilic infiltration of esophagus, with 2 of the patients showing eosinophilic gastroenteritis. Two out of the three patients developed esophageal stricture secondary to submucosal fibrosis.
- In 1985, eosinophilic infiltration was reported in esophageal mucosal biopsy of 11 patients with average age of 14.6 years. These patients had reflux symptoms and their eosinophil density was low. In retrospect, these were probably patients with gastroesophageal reflux disease (GERD).
- In 1989, Attwood et al described esophageal asthma, an episodic dysphagia with eosinophilic infiltrates.
- These investigators compared a group of 15 adults who presented with dysphagia without esophageal obstruction and normal pH monitoring to a group of 100 adults with GERD as defined by increased acid exposure in the distal esophagus.
- In 1993, Attwood et al reported 12 adults with dysphagia, normal pH monitoring, and dense esophageal eosinophilia. Seven patients had food hypersensitivity, and all required advanced intervention (dilatation and/or steroids in 1 case) for resolution of symptoms.
- In 1994, Straumann et al described a series of 10 patients with acute recurrent dysphagia seen over a 4-year period. These patients showed discrete endoscopic changes, and high concentrations of epithelial esophageal eosinophils. They improved following systemic steroid and antihistamine treatment.
- In 1995 the first publication in children was reported by Kelly et al. They identified 10 children who were diagnosed on clinical and histological grounds to have EoE.
- Six out of those ten had been subject to antireflux therapy without any symptomatic improvement. Two of these patients had already received fundoplication, and all responded well to amino acid formulas, suggesting an allergic etiology.
- The characteristics in pediatric EoE appeared to reflect greater amounts of regurgitation and failure to thrive, while the typical presentation in adults with EoE was dysphagia and food impaction.
- In 2003 the chronic nature of the natural history of EoE was described by Straumann et after the follow-up of 30 adults with EoE.
References
- ↑ Landres RT, Kuster GG, Strum WB (1978). "Eosinophilic esophagitis in a patient with vigorous achalasia". Gastroenterology. 74 (6): 1298–1301. PMID 648822.
- ↑ Picus D, Frank PH (1981). "Eosinophilic esophagitis". AJR Am J Roentgenol. 136 (5): 1001–3. doi:10.2214/ajr.136.5.1001. PMID 6784497.
- ↑ Matzinger MA, Daneman A (1983). "Esophageal involvement in eosinophilic gastroenteritis". Pediatr Radiol. 13 (1): 35–8. PMID 6844053.
- ↑ Feczko PJ, Halpert RD, Zonca M (1985). "Radiographic abnormalities in eosinophilic esophagitis". Gastrointest Radiol. 10 (4): 321–4. PMID 4054495.
- ↑ Lee RG (1985). "Marked eosinophilia in esophageal mucosal biopsies". Am. J. Surg. Pathol. 9 (7): 475–9. PMID 4091182.
- ↑ Attwood SE, Smyrk TC, Demeester TR, Jones JB (1993). "Esophageal eosinophilia with dysphagia. A distinct clinicopathologic syndrome". Dig. Dis. Sci. 38 (1): 109–16. PMID 8420741.
- ↑ Straumann A, Spichtin HP, Bernoulli R, Loosli J, Vögtlin J (1994). "[Idiopathic eosinophilic esophagitis: a frequently overlooked disease with typical clinical aspects and discrete endoscopic findings]". Schweiz Med Wochenschr (in German). 124 (33): 1419–29. PMID 7939509.
- ↑ Kelly KJ, Lazenby AJ, Rowe PC, Yardley JH, Perman JA, Sampson HA (1995). "Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acid-based formula". Gastroenterology. 109 (5): 1503–12. PMID 7557132.
- ↑ Straumann A, Spichtin HP, Grize L, Bucher KA, Beglinger C, Simon HU (2003). "Natural history of primary eosinophilic esophagitis: a follow-up of 30 adult patients for up to 11.5 years". Gastroenterology. 125 (6): 1660–9. PMID 14724818.
- ↑ Straumann A, Spichtin HP, Grize L, Bucher KA, Beglinger C, Simon HU (2003). "Natural history of primary eosinophilic esophagitis: a follow-up of 30 adult patients for up to 11.5 years". Gastroenterology. 125 (6): 1660–9. PMID 14724818.