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Eosinophilic gastroenteritis: diagnosis and clinical perspectives

Eosinophilic gastroenteritis (EGE) is a digestive disorder in children and adults that is characterized by eosinophilic infiltration in the stomach and intestine. The underlying molecular mechanisms predisposing to this disease are unknown, but it seems that hypersensitivity response plays a major r...

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Autores principales: Sunkara, Tagore, Rawla, Prashanth, Yarlagadda, Krishna Sowjanya, Gaduputi, Vinaya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556468/
https://www.ncbi.nlm.nih.gov/pubmed/31239747
http://dx.doi.org/10.2147/CEG.S173130
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author Sunkara, Tagore
Rawla, Prashanth
Yarlagadda, Krishna Sowjanya
Gaduputi, Vinaya
author_facet Sunkara, Tagore
Rawla, Prashanth
Yarlagadda, Krishna Sowjanya
Gaduputi, Vinaya
author_sort Sunkara, Tagore
collection PubMed
description Eosinophilic gastroenteritis (EGE) is a digestive disorder in children and adults that is characterized by eosinophilic infiltration in the stomach and intestine. The underlying molecular mechanisms predisposing to this disease are unknown, but it seems that hypersensitivity response plays a major role in its pathogenesis, as many patients have a history of seasonal allergies, food sensitivities, asthma, and eczema. Symptoms and clinical presentations vary, depending on the site and layer of the gastrointestinal wall infiltrated by eosinophils. Laboratory results, radiological findings, and endoscopy can provide important diagnostic evidence for EGE; however, the cornerstone of the diagnosis remains the histological examination of gastric and duodenal specimens for evidence of eosinophilic infiltration (>20 eosinophils per high-power field), and finally clinicians make the diagnosis in correlation with and by exclusion of other disorders associated with eosinophilic infiltration. Although spontaneous remission is reported in around 30%–40% of EGE cases, most patients require ongoing treatment. The management options for this disorder include both dietary and pharmacological approaches, with corticosteroids being the mainstay of therapy and highly effective. The subsequent course is quite variable. Some patients have no recurrences, while a few experience recurrent symptoms during or immediately after corticosteroid interruption. An alternative therapeutic armamentarium includes mast-cell stabilizers, leukotriene antagonists, antihistamines, immunomodulators, and biological agents. In this review, we provide a summary of the different diagnostic tools utilized in practice, as well as the different therapeutic approaches available for EGE management.
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spelling pubmed-65564682019-06-25 Eosinophilic gastroenteritis: diagnosis and clinical perspectives Sunkara, Tagore Rawla, Prashanth Yarlagadda, Krishna Sowjanya Gaduputi, Vinaya Clin Exp Gastroenterol Review Eosinophilic gastroenteritis (EGE) is a digestive disorder in children and adults that is characterized by eosinophilic infiltration in the stomach and intestine. The underlying molecular mechanisms predisposing to this disease are unknown, but it seems that hypersensitivity response plays a major role in its pathogenesis, as many patients have a history of seasonal allergies, food sensitivities, asthma, and eczema. Symptoms and clinical presentations vary, depending on the site and layer of the gastrointestinal wall infiltrated by eosinophils. Laboratory results, radiological findings, and endoscopy can provide important diagnostic evidence for EGE; however, the cornerstone of the diagnosis remains the histological examination of gastric and duodenal specimens for evidence of eosinophilic infiltration (>20 eosinophils per high-power field), and finally clinicians make the diagnosis in correlation with and by exclusion of other disorders associated with eosinophilic infiltration. Although spontaneous remission is reported in around 30%–40% of EGE cases, most patients require ongoing treatment. The management options for this disorder include both dietary and pharmacological approaches, with corticosteroids being the mainstay of therapy and highly effective. The subsequent course is quite variable. Some patients have no recurrences, while a few experience recurrent symptoms during or immediately after corticosteroid interruption. An alternative therapeutic armamentarium includes mast-cell stabilizers, leukotriene antagonists, antihistamines, immunomodulators, and biological agents. In this review, we provide a summary of the different diagnostic tools utilized in practice, as well as the different therapeutic approaches available for EGE management. Dove 2019-06-05 /pmc/articles/PMC6556468/ /pubmed/31239747 http://dx.doi.org/10.2147/CEG.S173130 Text en © 2019 Sunkara et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Sunkara, Tagore
Rawla, Prashanth
Yarlagadda, Krishna Sowjanya
Gaduputi, Vinaya
Eosinophilic gastroenteritis: diagnosis and clinical perspectives
title Eosinophilic gastroenteritis: diagnosis and clinical perspectives
title_full Eosinophilic gastroenteritis: diagnosis and clinical perspectives
title_fullStr Eosinophilic gastroenteritis: diagnosis and clinical perspectives
title_full_unstemmed Eosinophilic gastroenteritis: diagnosis and clinical perspectives
title_short Eosinophilic gastroenteritis: diagnosis and clinical perspectives
title_sort eosinophilic gastroenteritis: diagnosis and clinical perspectives
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556468/
https://www.ncbi.nlm.nih.gov/pubmed/31239747
http://dx.doi.org/10.2147/CEG.S173130
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