Advertisement

Gastro-News

, Volume 5, Issue 3, pp 32–41 | Cite as

Chronisch-entzündliche Erkrankung der Speiseröhre

Klinik und Histologie bei eosinophiler Ösophagitis nicht isoliert betrachten

  • Ulrike von Arnim
zertifizierte fortbildung

Zusammenfassung

Nachdem die eosinophile Ösophagitis lange als „seltene Erkrankung“ angesehen wurde, haben Ärzte in den letzten zwei Dekaden die Diagnose immer häufiger gestellt. Sie ist nach der gastroösophagealen Refluxerkrankung die zweithäufigste entzündliche Erkrankung der Speiseröhre, deren Therapie mit Protonenpumpeninhibitoren, topischen Steroiden oder Eliminationsdiät auf eine langfristige klinische und histologische Remission abzielt.

Literatur

  1. 1.
    Furuta GT, Katzka DA. Eosinophilic Esophagitis. The New England journal of medicine 2015; 373 (17): 1640–1648.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Arias Á, Pérez-Martínez I, Tenías JM, Lucendo AJ. Systematic review with meta-analysis: the incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Alimentary pharmacology & therapeutics 2016; 43(1): 3–15.CrossRefGoogle Scholar
  3. 3.
    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; 133(4): 1342–1363.CrossRefPubMedGoogle Scholar
  4. 4.
    Dellon ES, Gonsalves N, Hirano I et al. ACG clinical guideline: Evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). The American journal of gastroenterology 2013; 108(5): 679–92; quiz 693.CrossRefPubMedGoogle Scholar
  5. 5.
    Liacouras CA, Furuta GT, Hirano I et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. The Journal of allergy and clinical immunology 2011; 128(1): 3–20.e6; quiz 21-2.CrossRefPubMedGoogle Scholar
  6. 6.
    Papadopoulou A, Koletzko S, Heuschkel R et al. Management guidelines of eosinophilic esophagitis in childhood. Journal of pediatric gastroenterology and nutrition 2014; 58(1): 107–118.CrossRefPubMedGoogle Scholar
  7. 7.
    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 gastroenterology journal 2017; 5(3): 335–358.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Molina-Infante J, Ferrando-Lamana L, Ripoll C et al. Esophageal eosinophilic infiltration responds to proton pump inhibition in most adults. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2011; 9(2): 110–117.CrossRefPubMedGoogle Scholar
  9. 9.
    Molina-Infante J, Bredenoord AJ, Cheng E et al. Proton pump inhibitor-responsive oesophageal eosinophilia: an entity challenging current diagnostic criteria for eosinophilic oesophagitis. Gut 2016; 65(3): 524–531.CrossRefPubMedGoogle Scholar
  10. 10.
    Arias Á, Lucendo AJ. Prevalence of eosinophilic oesophagitis in adult patients in a central region of Spain. European journal of gastroenterology & hepatology 2013; 25(2): 208–212.CrossRefGoogle Scholar
  11. 11.
    Giriens B, Yan P, Safroneeva E et al. Escalating incidence of eosinophilic esophagitis in Canton of Vaud, Switzerland, 1993-2013: a population-based study. Allergy 2015; 70(12): 1633–1639.CrossRefPubMedGoogle Scholar
  12. 12.
    Foroutan M, Norouzi A, Molaei M et al. Eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease. Digestive diseases and sciences 2010; 55(1): 28–31.CrossRefPubMedGoogle Scholar
  13. 13.
    Veerappan GR, Perry JL, Duncan TJ et al. Prevalence of eosinophilic esophagitis in an adult population undergoing upper endoscopy: a prospective study. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2009; 7(4): 420–6, 426.e1-2.CrossRefPubMedGoogle Scholar
  14. 14.
    Kapel RC, Miller JK, Torres C et al. Eosinophilic esophagitis: a prevalent disease in the United States that affects all age groups. Gastroenterology 2008; 134(5): 1316–1321.CrossRefPubMedGoogle Scholar
  15. 15.
    Dellon ES, Jensen ET, Martin CF et al. Prevalence of eosinophilic esophagitis in the United States. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2014; 12(4): 589–96.e1.CrossRefPubMedGoogle Scholar
  16. 16.
    Hruz P, Straumann A, Bussmann C et al. Escalating incidence of eosinophilic esophagitis: a 20-year prospective, population-based study in Olten County, Switzerland. The Journal of allergy and clinical immunology 2011; 128(6): 1349–1350.e5.CrossRefPubMedGoogle Scholar
  17. 17.
    Alexander ES, Martin LJ, Collins MH et al. Twin and family studies reveal strong environmental and weaker genetic cues explaining heritability of eosinophilic esophagitis. The Journal of allergy and clinical immunology 2014; 134(5): 1084–1092.e1.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    González-Cervera J, Arias Á, Redondo-González O et al. Association between atopic manifestations and eosinophilic esophagitis: A systematic review and meta-analysis. Annals of allergy, asthma & immunology official publication of the American College of Allergy, Asthma, & Immunology 2017; 118(5): 582–590.e2.CrossRefGoogle Scholar
  19. 19.
    Arnim U von, Röhl F, Miehlke S et al. Clinical symptom tool that raises the index of suspicion for eosinophilic oesophagitis in adults and drives earlier biopsy for definitive diagnosis. Alimentary pharmacology & therapeutics 2017; 45(3): 417–426.CrossRefGoogle Scholar
  20. 20.
    Straumann A, Bauer M, Fischer B et al. Idiopathic eosinophilic esophagitis is associated with a T(H)2-type allergic inflammatory response. The Journal of allergy and clinical immunology 2001; 108(6): 954–961.CrossRefPubMedGoogle Scholar
  21. 21.
    Rothenberg ME. Biology and treatment of eosinophilic esophagitis. Gastroenterology 2009; 137 (4): 1238–1249.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Straumann A, Aceves SS, Blanchard C et al. Pediatric and adult eosinophilic esophagitis: similarities and differences. Allergy 2012; 67(4): 477–490.CrossRefPubMedGoogle Scholar
  23. 23.
    Franciosi JP, Liacouras CA. Eosinophilic esophagitis. Immunology and allergy clinics of North America 2009; 29(1): 19–27, viii.CrossRefPubMedGoogle Scholar
  24. 24.
    Dellon ES, Gibbs WB, Fritchie KJ et al. Clinical, endoscopic, and histologic findings distinguish eosinophilic esophagitis from gastroesophageal reflux disease. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2009; 7(12): 1305–13; quiz 1261.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Kerlin P, Jones D, Remedios M, Campbell C. Prevalence of eosinophilic esophagitis in adults with food bolus obstruction of the esophagus. Journal of clinical gastroenterology 2007; 41(4): 356–361.CrossRefPubMedGoogle Scholar
  26. 26.
    Poh CH, Gasiorowska A, Navarro-Rodriguez T et al. Upper GI tract findings in patients with heartburn in whom proton pump inhibitor treatment failed versus those not receiving antireflux treatment. Gastrointestinal endoscopy 2010; 71(1): 28–34.CrossRefPubMedGoogle Scholar
  27. 27.
    Roy-Ghanta S, Larosa DF, Katzka DA. Atopic characteristics of adult patients with eosinophilic esophagitis. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2008; 6(5): 531–535.CrossRefPubMedGoogle Scholar
  28. 28.
    Arnim U von, Wex T, Röhl F et al. Identification of clinical and laboratory markers for predicting eosinophilic esophagitis in adults. Digestion 2011; 84(4): 323–327.CrossRefGoogle Scholar
  29. 29.
    Erwin EA, James HR, Gutekunst HM et al. Serum IgE measurement and detection of food allergy in pediatric patients with eosinophilic esophagitis. Annals of allergy, asthma & immunology official publication of the American College of Allergy, Asthma, & Immunology 2010; 104(6): 496–502.Google Scholar
  30. 30.
    Kim HP, Vance RB, Shaheen NJ, Dellon ES. The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2012; 10(9): 988–96.e5.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Hirano I, Moy N, Heckman MG et al. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system. Gut 2013; 62(4): 489–495.CrossRefGoogle Scholar
  32. 32.
    Dellon ES, Cotton CC, Gebhart JH et al. Accuracy of the Eosinophilic Esophagitis Endoscopic Reference Score in Diagnosis and Determining Response to Treatment. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2016; 14(1): 31–39.CrossRefPubMedGoogle Scholar
  33. 33.
    Rodríguez-Sánchez J, Barrio-Andrés J, Nantes Castillejo O et al. The Endoscopic Reference Score shows modest accuracy to predict either clinical or histological activity in adult patients with eosinophilic oesophagitis. Alimentary pharmacology & therapeutics 2017; 45(2): 300–309.CrossRefGoogle Scholar
  34. 34.
    Nielsen JA, Lager DJ, Lewin M et al. The optimal number of biopsy fragments to establish a morphologic diagnosis of eosinophilic esophagitis. The American journal of gastroenterology 2014; 109(4): 515–520.CrossRefPubMedGoogle Scholar
  35. 35.
    Gonsalves N, Policarpio-Nicolas M, Zhang Q et al. Histopathologic variability and endoscopic correlates in adults with eosinophilic esophagitis. Gastrointestinal endoscopy 2006; 64(3): 313–319.CrossRefPubMedGoogle Scholar
  36. 36.
    Collins MH, Martin LJ, Alexander ES et al. Newly developed and validated eosinophilic esophagitis histology scoring system and evidence that it outperforms peak eosinophil count for disease diagnosis and monitoring. Diseases of the esophagus official journal of the International Society for Diseases of the Esophagus 2017; 303): 1–8.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Teitelbaum JE, Fox VL, Twarog FJ et al. Eosinophilic esophagitis in children: immunopathological analysis and response to fluticasone propionate. Gastroenterology 2002; 122(5): 1216–1225.CrossRefPubMedGoogle Scholar
  38. 38.
    Straumann A, Conus S, Degen L et al. Budesonide is effective in adolescent and adult patients with active eosinophilic esophagitis. Gastroenterology 2010; 139(5): 1526–37, 1537.e1.CrossRefPubMedGoogle Scholar
  39. 39.
    Dohil R, Newbury R, Fox L et al. Oral viscous budesonide is effective in children with eosinophilic esophagitis in a randomized, placebo-controlled trial. Gastroenterology 2010; 139(2): 418–429.CrossRefPubMedGoogle Scholar
  40. 40.
    Dellon ES, Sheikh A, Speck O et al. Viscous topical is more effective than nebulized steroid therapy for patients with eosinophilic esophagitis. Gastroenterology 2012; 143(2): 321–4.e1.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Sawas T, Dhalla S, Sayyar M et al. Systematic review with meta-analysis: pharmacological interventions for eosinophilic oesophagitis. Alimentary pharmacology & therapeutics 2015; 41(9): 797–806.CrossRefGoogle Scholar
  42. 42.
    Miehlke S, Hruz P, Vieth M et al. A randomised, double-blind trial comparing budesonide formulations and dosages for short-term treatment of eosinophilic oesophagitis. Gut 2016; 65(3): 390–399.CrossRefPubMedGoogle Scholar
  43. 43.
    Lucendo AJ, Miehlke S, Vieth M, Schlag C, von Arnim U, Molina-Infante J et al. Budesonide orodispersible tablets are highly effective for treatment of active eosinophilic esophagitis: Results from a randomized, double-blind, placebo-controlled, pivotal multicenter trial (EOS1). Gastroenterology 2017;152(5, Suppl.1):S-207.Google Scholar
  44. 44.
    Murali AR, Gupta A, Attar BM et al. Topical steroids in eosinophilic esophagitis: Systematic review and meta-analysis of placebo-controlled randomized clinical trials. Journal of gastroenterology and hepatology 2016; 31(6): 1111–1119.CrossRefPubMedGoogle Scholar
  45. 45.
    Dranove JE, Horn DS, Davis MA et al. Predictors of response to proton pump inhibitor therapy among children with significant esophageal eosinophilia. The Journal of pediatrics 2009; 154(1): 96–100.CrossRefPubMedGoogle Scholar
  46. 46.
    Sayej WN, Patel R, Baker RD et al. Treatment with high-dose proton pump inhibitors helps distinguish eosinophilic esophagitis from noneosinophilic esophagitis. Journal of pediatric gastroenterology and nutrition 2009; 49(4): 393–399.CrossRefPubMedGoogle Scholar
  47. 47.
    Liacouras CA, Spergel JM, Ruchelli E et al. Eosinophilic esophagitis: a 10-year experience in 381 children. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2005; 3(12): 1198–1206.CrossRefPubMedGoogle Scholar
  48. 48.
    Attwood, S E A, Lewis CJ, Bronder CS et al. Eosinophilic oesophagitis: a novel treatment using Montelukast. Gut 2003; 52(2): 181–185.Google Scholar
  49. 49.
    Stumphy J, Al-Zubeidi D, Guerin L et al. Observations on use of montelukast in pediatric eosinophilic esophagitis: insights for the future. Diseases of the esophagus official journal of the International Society for Diseases of the Esophagus 2011; 24(4): 229–234.CrossRefPubMedGoogle Scholar
  50. 50.
    Alexander JA, Ravi K, Enders FT et al. Montelukast Does not Maintain Symptom Remission After Topical Steroid Therapy for Eosinophilic Esophagitis. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2017; 15(2): 214–221.e2.CrossRefPubMedGoogle Scholar
  51. 51.
    Lucendo AJ, De Rezende, Livia C, Jiménez-Contreras S et al. Montelukast was inefficient in maintaining steroid-induced remission in adult eosinophilic esophagitis. Digestive diseases and sciences 2011; 56(12): 3551–3558.CrossRefPubMedGoogle Scholar
  52. 52.
    Straumann A, Conus S, Grzonka P et al. Anti-interleukin-5 antibody treatment (mepolizumab) in active eosinophilic oesophagitis: a randomised, placebo-controlled, double-blind trial. Gut 2010; 59(1): 21–30.CrossRefPubMedGoogle Scholar
  53. 53.
    Assa’ad AH, Gupta SK, Collins MH et al. An antibody against IL-5 reduces numbers of esophageal intraepithelial eosinophils in children with eosinophilic esophagitis. Gastroenterology 2011; 141(5): 1593–1604.CrossRefPubMedGoogle Scholar
  54. 54.
    Spergel JM, Rothenberg ME, Collins MH et al. Reslizumab in children and adolescents with eosinophilic esophagitis: results of a double-blind, randomized, placebo-controlled trial. The Journal of allergy and clinical immunology 2012; 129(2): 456–63, 463.e1–3.CrossRefPubMedGoogle Scholar
  55. 55.
    Clayton F, Fang JC, Gleich GJ et al. Eosinophilic esophagitis in adults is associated with IgG4 and not mediated by IgE. Gastroenterology 2014; 147(3): 602–609.CrossRefPubMedGoogle Scholar
  56. 56.
    Straumann A, Bussmann C, Conus S et al. Anti-TNF-alpha (infliximab) therapy for severe adult eosinophilic esophagitis. The Journal of allergy and clinical immunology 2008; 122(2): 425–427.CrossRefPubMedGoogle Scholar
  57. 57.
    Kelly KJ, Lazenby AJ, Rowe PC et al. Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acid-based formula. Gastroenterology 1995; 109(5): 1503–1512.CrossRefPubMedGoogle Scholar
  58. 58.
    Markowitz JE, Spergel JM, Ruchelli E, Liacouras CA. Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents. The American journal of gastroenterology 2003; 98 (4): 777–782.CrossRefPubMedGoogle Scholar
  59. 59.
    Arias A, González-Cervera J, Tenias JM, Lucendo AJ. Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis. Gastroenterology 2014; 146(7): 1639–1648.CrossRefPubMedGoogle Scholar
  60. 60.
    Kagalwalla AF, Sentongo TA, Ritz S et al. Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association 2006; 4(9): 1097–1102.CrossRefPubMedGoogle Scholar
  61. 61.
    Molina-Infante J, Arias A, Barrio J et al. Four-food group elimination diet for adult eosinophilic esophagitis: A prospective multicenter study. The Journal of allergy and clinical immunology 2014; 134(5): 1093–9.e1.CrossRefPubMedGoogle Scholar
  62. 62.
    Moawad FJ, Cheatham JG, DeZee KJ. Meta-analysis: the safety and efficacy of dilation in eosinophilic oesophagitis. Alimentary pharmacology & therapeutics 2013; 38(7): 713–720.CrossRefGoogle Scholar
  63. 63.
    Robles-Medranda C, Villard F, Le Gall C et al. Severe dysphagia in children with eosinophilic esophagitis and esophageal stricture: an indication for balloon dilation? Journal of pediatric gastroenterology and nutrition 2010; 50(5): 516–520.PubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Gastroenterologie, Hepatologie und Infektiologie Universitätsklinikum MagdeburgMagdeburgDeutschland

Personalised recommendations