小结
定义
病史和体格检查
关键诊断因素
- dysphagia
- food avoidance and modification behaviors
其他诊断因素
- heartburn
- chest discomfort
- nausea/vomiting
- regurgitation
- abdominal pain
- failure to thrive
- irritability
危险因素
- family history of EoE
- male sex
- atopic disease
- children and younger adults
- white ancestry
诊断性检查
首要检查
- esophagogastroduodenoscopy
- esophageal biopsy
- CBC with differential
新兴检查
- transnasal endoscopy
- esophageal string test
- cytosponge
- Esophageal physiological testing
- EoE diagnostic panel
治疗流程
at initial diagnosis
response to initial therapy
nonresponse or relapse
撰稿人
作者
Jenny Epstein, MB ChB MRCPCH PhD
Consultant Paediatric Gastroenterologist
Chelsea and Westminster Hospital
London
UK
利益声明
JE is a member of the advisory board for Dr Falk Pharma, manufacturer of Jorveza, a new formulation of budesonide licensed for adults with eosinophilic esophagitis (EoE), and Nurtricia for infant functional bowel disorders. She has received honoraria from Dr Falk Pharma to speak on EoE and has been sponsored by Dr Falk Pharma, Abbvie and Nutricia to attend national and international meetings. JE is a member of BSPGHAN IBD working group, medical advisor to CICRA and Coeliac UK, member of CCUK IBD working group, member of BSG EoE Guideline development group, member of NICE Guideline update committee for Crohn disease and ulcerative colitis, member of NICE Diagnostics, and sits on the NICE advisory committee for personalized treatment in Crohn disease.
鸣谢
Dr Jenny Epstein wishes to gratefully acknowledge Dr Evan S. Dellon, the previous contributor to this topic.
利益声明
ESD is an author of a number of references cited in this topic.
同行评议者
David Katzka, MD
Professor of Medicine
Mayo Clinic
Rochester
MN
利益声明
DK has served on advisory boards (Adare, Receptos) and received research funding (Covidien).
Alexandra Papadopoulou, MD
Honorary Professor
Chief of the Division of Gastroenterology and Hepatology
First Department of Pediatrics
University of Athens
Agia Sofia Children’s Hospital
Athens
Greece
利益声明
AP has received speaker’s honorariums from Nestle and Nutricia; research grants from Biogaia/Nutricia/Abbvie; consultant’s fee from Receptos.
参考文献
关键文献
Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011 Jul;128(1):3-20.全文 摘要
Furuta GT, Liacouras CA, Collins MH, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology. 2007 Oct;133(4):1342-63.全文 摘要
Dhar A, Haboubi HN, Attwood SE, et al. British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults. Gut. 2022 Aug;71(8):1459-87.全文 摘要
Wolf WA, Jerath MR, Sperry SL, et al. Dietary elimination therapy is an effective option for adults with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2014 Aug;12(8):1272-9.全文 摘要
Lucendo AJ, Molina-Infante J, Arias Á, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J. 2017 Apr;5(3):335-58.全文 摘要
Hirano I, Chan ES, Rank MA, et al. AGA institute and the joint task force on allergy-immunology practice parameters clinical guidelines for the management of eosinophilic esophagitis. Ann Allergy Asthma Immunol. 2020 May;124(5):416-23.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Gastroesophageal reflux disease (GERD)
- Eosinophilic gastroenteritis
- Achalasia
更多 鉴别诊断指南
- Joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults
- Practice guideline: adverse events associated with EGD and EGD-related techniques
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