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Eosinophilic Gastrointestinal Disorders Pathology
Eosinophilic gastrointestinal disorders (EGID) are characterized pathologically by excess eosinophils in mucosal biopsies of one or multiple sites in the gastrointestinal (GI) tract, simultaneously or sequentially. Eosinophilic esophagitis (EoE) is the best characterized EGID, and in most patients i...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775510/ https://www.ncbi.nlm.nih.gov/pubmed/29379785 http://dx.doi.org/10.3389/fmed.2017.00261 |
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author | Collins, Margaret H. Capocelli, Kelley Yang, Guang-Yu |
author_facet | Collins, Margaret H. Capocelli, Kelley Yang, Guang-Yu |
author_sort | Collins, Margaret H. |
collection | PubMed |
description | Eosinophilic gastrointestinal disorders (EGID) are characterized pathologically by excess eosinophils in mucosal biopsies of one or multiple sites in the gastrointestinal (GI) tract, simultaneously or sequentially. Eosinophilic esophagitis (EoE) is the best characterized EGID, and in most patients it is an abnormal immune-mediated response to food antigens. Current recommendations for diagnosis include signs and symptoms of esophageal dysfunction that do not respond to proton-pump inhibitor therapy, and esophageal biopsies that exhibit at least 15 intraepithelial eosinophils in at least one high power field (HPF). Therapy consists of swallowed glucocorticoids or dietary elimination. Eosinophilic gastritis (EG) is the second most common form of EGID, but like all forms of EGID except EoE consensus recommendations for either clinical or pathological diagnosis do not exist. EG may be associated clinically with peripheral blood eosinophilia, hypoalbuminemia, and anemia, and pathologically with marked expansion of lamina propria by dense eosinophilic infiltrates. Eosinophilic enteritis (EE) may be subdivided into eosinophilic duodenitis, eosinophilic jejunitis, and eosinophilic ileitis. Most investigators believe that EE rarely, if ever, exists as a solitary form of EGID and is encountered only in patients who have at least one other affected portion of the GI tract. Eosinophilic colitis (EC) is perhaps the most enigmatic EGID. Distinction of EC from inflammatory bowel disease may be problematic especially in children. Multiple possible etiologies for EGID include hypereosinophilic syndrome, drug reactions, etc. Currently, the only etiology that can be identified histologically is parasitic infestation, if a portion of an invasive parasite is found in mucosal biopsies. This review will provide guidelines for the pathologic diagnosis of the various forms of EGID. |
format | Online Article Text |
id | pubmed-5775510 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-57755102018-01-29 Eosinophilic Gastrointestinal Disorders Pathology Collins, Margaret H. Capocelli, Kelley Yang, Guang-Yu Front Med (Lausanne) Medicine Eosinophilic gastrointestinal disorders (EGID) are characterized pathologically by excess eosinophils in mucosal biopsies of one or multiple sites in the gastrointestinal (GI) tract, simultaneously or sequentially. Eosinophilic esophagitis (EoE) is the best characterized EGID, and in most patients it is an abnormal immune-mediated response to food antigens. Current recommendations for diagnosis include signs and symptoms of esophageal dysfunction that do not respond to proton-pump inhibitor therapy, and esophageal biopsies that exhibit at least 15 intraepithelial eosinophils in at least one high power field (HPF). Therapy consists of swallowed glucocorticoids or dietary elimination. Eosinophilic gastritis (EG) is the second most common form of EGID, but like all forms of EGID except EoE consensus recommendations for either clinical or pathological diagnosis do not exist. EG may be associated clinically with peripheral blood eosinophilia, hypoalbuminemia, and anemia, and pathologically with marked expansion of lamina propria by dense eosinophilic infiltrates. Eosinophilic enteritis (EE) may be subdivided into eosinophilic duodenitis, eosinophilic jejunitis, and eosinophilic ileitis. Most investigators believe that EE rarely, if ever, exists as a solitary form of EGID and is encountered only in patients who have at least one other affected portion of the GI tract. Eosinophilic colitis (EC) is perhaps the most enigmatic EGID. Distinction of EC from inflammatory bowel disease may be problematic especially in children. Multiple possible etiologies for EGID include hypereosinophilic syndrome, drug reactions, etc. Currently, the only etiology that can be identified histologically is parasitic infestation, if a portion of an invasive parasite is found in mucosal biopsies. This review will provide guidelines for the pathologic diagnosis of the various forms of EGID. Frontiers Media S.A. 2018-01-15 /pmc/articles/PMC5775510/ /pubmed/29379785 http://dx.doi.org/10.3389/fmed.2017.00261 Text en Copyright © 2018 Collins, Capocelli and Yang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Collins, Margaret H. Capocelli, Kelley Yang, Guang-Yu Eosinophilic Gastrointestinal Disorders Pathology |
title | Eosinophilic Gastrointestinal Disorders Pathology |
title_full | Eosinophilic Gastrointestinal Disorders Pathology |
title_fullStr | Eosinophilic Gastrointestinal Disorders Pathology |
title_full_unstemmed | Eosinophilic Gastrointestinal Disorders Pathology |
title_short | Eosinophilic Gastrointestinal Disorders Pathology |
title_sort | eosinophilic gastrointestinal disorders pathology |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775510/ https://www.ncbi.nlm.nih.gov/pubmed/29379785 http://dx.doi.org/10.3389/fmed.2017.00261 |
work_keys_str_mv | AT collinsmargareth eosinophilicgastrointestinaldisorderspathology AT capocellikelley eosinophilicgastrointestinaldisorderspathology AT yangguangyu eosinophilicgastrointestinaldisorderspathology |