ACG Clinical Guideline: Evidenced Based Approach to the Diagnosis and Management of Esophageal Eosinophilia and Eosinophilic Esophagitis (EoE)

@article{Dellon2013ACGCG,
  title={ACG Clinical Guideline: Evidenced Based Approach to the Diagnosis and Management of Esophageal Eosinophilia and Eosinophilic Esophagitis (EoE)},
  author={E. Dellon and N. Gonsalves and I. Hirano and G. Furuta and C. Liacouras and D. Katzka},
  journal={The American Journal of Gastroenterology},
  year={2013},
  volume={108},
  pages={679-692}
}
Esophageal eosinophilia and eosinophilic esophagitis (EoE) are increasingly recognized and prevalent conditions, which now represent common clinical problems encountered by gastroenterologists, pathologists, and allergists. The study of EoE has become a dynamic field with an evolving understanding of the pathogenesis, diagnosis, and treatment. Although there are limited data supporting management decisions, clinical parameters are needed to guide the care of patients with eosinophilic… Expand

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References

SHOWING 1-10 OF 133 REFERENCES
Eosinophilic esophagitis: updated consensus recommendations for children and adults.
TLDR
A new conceptual definition is proposed highlighting that EoE represents a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. Expand
Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment.
TLDR
A multidisciplinary task force of 31 physicians assembled with the goal of determining diagnostic criteria and making recommendations for evaluation and treatment of children and adults with suspected eosinophilic esophagitis (EE) provided current recommendations for care of affected patients. Expand
Transient PPI Responsive Esophageal Eosinophilia May Be a Clinical Sub-phenotype of Pediatric Eosinophilic Esophagitis
TLDR
PPIs appear to be capable of transiently resolving multiple inflammatory cell subsets including eosinophils, mast cells, and CD45RO cells. Expand
Variability in Diagnostic Criteria for Eosinophilic Esophagitis: A Systematic Review
TLDR
Significant variability in diagnostic criteria for eosinophilic esophagitis exists, and in a large proportion of studies, criteria are not reported, so conclusions drawn from the cumulative EoE literature should be viewed with caution. Expand
Eosinophilic esophagitis: a 10-year experience in 381 children.
  • C. Liacouras, J. Spergel, +8 authors J. Markowitz
  • Medicine
  • Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2005
TLDR
Medications such as corticosteroids are effective; however, upon withdrawal, EoE recurs, and the removal of dietary antigens significantly improved clinical symptoms and esophageal histology in 98% of patients. Expand
Elemental Diet Is an Effective Treatment for Eosinophilic Esophagitis in Children and Adolescents
TLDR
Elemental diet resulted in striking improvement in both symptoms and histologic evidence of disease in children and adolescents with EoE, as identified by strict diagnostic criteria. Expand
Eosinophilic esophagitis in adults: clinical, endoscopic, histologic findings, and response to treatment with fluticasone propionate.
TLDR
Eosinophilic esophagitis is a distinct entity that may coexist with gastroesophageal reflux and swallowed fluticasone propionate is an effective treatment. Expand
Eosinophilic esophagitis: history, nomenclature, and diagnostic guidelines.
  • N. Gonsalves
  • Medicine
  • Gastrointestinal endoscopy clinics of North America
  • 2008
TLDR
The history and nomenclature of eosinophilic esophagitis and its evolution as a separate entity from gastroesophageal reflux disease are focused on. Expand
Histopathologic Variability in Children With Eosinophilic Esophagitis
TLDR
Significant histologic variability exists among biopsy specimens from pediatric patients with EoE, which can persist following proton pump inhibitor therapy in patients withEoE and gastroesophageal reflux disease when the latter is defined by increased distal esophageAL acid exposure. Expand
Clinical, endoscopic, and histologic findings distinguish eosinophilic esophagitis from gastroesophageal reflux disease.
  • E. Dellon, W. Gibbs, +4 authors N. Shaheen
  • Medicine
  • Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2009
TLDR
A set of readily available and routinely measured variables that differentiate EoE from GERD are identified and use of this type of analysis with patients suspected to have EiE might lead to more accurate diagnoses. Expand
...
1
2
3
4
5
...