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Eosinophilic Esophagitis

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Pediatric Food Allergy

Abstract

Eosinophilic esophagitis (EoE) is a common cause of chronic esophagitis and is one of the leading causes of dysphagia and food impaction in children. EoE is defined as a chronic immune-mediated condition characterized by esophageal symptoms in the setting of eosinophilic predominant inflammation of the esophagus. While genetics and the environment have been implicated in the development of EoE, the pathogenesis still remains unknown.

If EoE is not recognized or treated, it can progress to esophageal stricture and functional abnormalities that can impair the quality of life of children. Currently, diagnosis is made by upper endoscopy with biopsy. A variety of treatment approaches are used in the care of EoE patients, including proton pump inhibitors, dietary interventions, and swallowed topical steroids. There is a plethora of research studies underway to better understand this disease and to identify new treatment modalities.

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References

  1. Lucendo AJ, Molina-Infante J, Arias A, von Arnim U, Bredenoord AJ, Bussmann C, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J. 2017;5(3):335–58.

    PubMed  PubMed Central  Google Scholar 

  2. Arias A, Perez-Martinez I, Tenias JM, Lucendo AJ. Systematic review with meta-analysis: the incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Aliment Pharmacol Ther. 2016;43(1):3–15.

    CAS  PubMed  Google Scholar 

  3. Soon IS, Butzner JD, Kaplan GG, deBruyn JC. Incidence and prevalence of eosinophilic esophagitis in children. J Pediatr Gastroenterol Nutr. 2013;57(1):72–80.

    PubMed  Google Scholar 

  4. Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128(1):3–20 e6; quiz 1–2

    Google Scholar 

  5. Davis BP. Pathophysiology of eosinophilic esophagitis. Clin Rev Allergy Immunol. 2018 Aug;55(1):19–42.

    CAS  PubMed  Google Scholar 

  6. Kelly KJ, Lazenby AJ, Rowe PC, Yardley JH, Perman JA, Sampson HA. Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acid-based formula. Gastroenterology. 1995;109(5):1503–12.

    CAS  PubMed  Google Scholar 

  7. Arias A, Lucendo AJ. Dietary therapies for eosinophilic esophagitis. Expert Rev Clin Immunol. 2014;10(1):133–42.

    CAS  PubMed  Google Scholar 

  8. Kagalwalla AF, Sentongo TA, Ritz S, Hess T, Nelson SP, Emerick KM, et al. Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2006;4(9):1097–102.

    PubMed  Google Scholar 

  9. Markowitz JE, Spergel JM, Ruchelli E, Liacouras CA. Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents. Am J Gastroenterol. 2003;98(4):777–82.

    CAS  PubMed  Google Scholar 

  10. Spergel JM, Brown-Whitehorn TF, Cianferoni A, Shuker M, Wang ML, Verma R, et al. Identification of causative foods in children with eosinophilic esophagitis treated with an elimination diet. J Allergy Clin Immunol. 2012;130(2):461–7 e5.

    PubMed  Google Scholar 

  11. Kagalwalla AF, Wechsler JB, Amsden K, Schwartz S, Makhija M, Olive A, et al. Efficacy of a 4-food elimination diet for children with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2017;15(11):1698–707 e7.

    PubMed  PubMed Central  Google Scholar 

  12. Molina-Infante J, Arias A, Alcedo J, Garcia-Romero R, Casabona-Frances S, Prieto-Garcia A, et al. Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: the 2-4-6 study. J Allergy Clin Immunol. 2018;141(4):1365–72.

    PubMed  Google Scholar 

  13. Spergel JM, Brown-Whitehorn TF, Beausoleil JL, Franciosi J, Shuker M, Verma R, et al. 14 years of eosinophilic esophagitis: clinical features and prognosis. J Pediatr Gastroenterol Nutr. 2009;48(1):30–6.

    PubMed  Google Scholar 

  14. Blanchard C, Wang N, Stringer KF, Mishra A, Fulkerson PC, Abonia JP, et al. Eotaxin-3 and a uniquely conserved gene-expression profile in eosinophilic esophagitis. J Clin Invest. 2006;116(2):536–47.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Bullock JZ, Villanueva JM, Blanchard C, Filipovich AH, Putnam PE, Collins MH, et al. Interplay of adaptive th2 immunity with eotaxin-3/c-C chemokine receptor 3 in eosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2007;45(1):22–31.

    CAS  PubMed  Google Scholar 

  16. Rothenberg ME, Spergel JM, Sherrill JD, Annaiah K, Martin LJ, Cianferoni A, et al. Common variants at 5q22 associate with pediatric eosinophilic esophagitis. Nat Genet. 2010;42(4):289–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Ahrens R, Waddell A, Seidu L, Blanchard C, Carey R, Forbes E, et al. Intestinal macrophage/epithelial cell-derived CCL11/eotaxin-1 mediates eosinophil recruitment and function in pediatric ulcerative colitis. J Immunol. 2008;181(10):7390–9.

    CAS  PubMed  Google Scholar 

  18. Konikoff MR, Blanchard C, Kirby C, Buckmeier BK, Cohen MB, Heubi JE, et al. Potential of blood eosinophils, eosinophil-derived neurotoxin, and eotaxin-3 as biomarkers of eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2006;4(11):1328–36.

    CAS  PubMed  Google Scholar 

  19. Schoepfer A, Safroneeva E, Straumann A. Eosinophilic esophagitis: impact of latest insights into pathophysiology on therapeutic strategies. Dig Dis. 2016;34(5):462–8.

    PubMed  Google Scholar 

  20. Rocha R, Vitor AB, Trindade E, Lima R, Tavares M, Lopes J, et al. Omalizumab in the treatment of eosinophilic esophagitis and food allergy. Eur J Pediatr. 2011;170(11):1471–4.

    CAS  PubMed  Google Scholar 

  21. Spergel JM, Andrews T, Brown-Whitehorn TF, Beausoleil JL, Liacouras CA. Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests. Ann Allergy Asthma Immunol. 2005;95(4):336–43.

    PubMed  Google Scholar 

  22. Noel RJ, Putnam PE, Rothenberg ME. Eosinophilic esophagitis. N Engl J Med. 2004;351(9):940–1.

    CAS  PubMed  Google Scholar 

  23. Assa’ad AH, Putnam PE, Collins MH, Akers RM, Jameson SC, Kirby CL, et al. Pediatric patients with eosinophilic esophagitis: an 8-year follow-up. J Allergy Clin Immunol. 2007;119(3):731–8.

    PubMed  Google Scholar 

  24. Maggadottir SM, Hill DA, Ruymann K, Brown-Whitehorn TF, Cianferoni A, Shuker M, et al. Resolution of acute IgE-mediated allergy with development of eosinophilic esophagitis triggered by the same food. J Allergy Clin Immunol. 2014;133(5):1487–9, 9 e1.

    CAS  PubMed  Google Scholar 

  25. Schuyler AJ, Wilson JM, Tripathi A, Commins SP, Ogbogu PU, Kruzsewski PG, et al. Specific IgG4 antibodies to cow’s milk proteins in pediatric patients with eosinophilic esophagitis. J Allergy Clin Immunol. 2018;142(1):139–48 e12.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Clayton F, Fang JC, Gleich GJ, Lucendo AJ, Olalla JM, Vinson LA, et al. Eosinophilic esophagitis in adults is associated with IgG4 and not mediated by IgE. Gastroenterology. 2014;147(3):602–9.

    CAS  PubMed  Google Scholar 

  27. Rosenberg CE, Mingler MK, Caldwell JM, Collins MH, Fulkerson PC, Morris DW, et al. Esophageal IgG4 levels correlate with histopathologic and transcriptomic features in eosinophilic esophagitis. Allergy. 2018;73(9):1892–901. https://doi.org/10.1111/all.13486.

    Article  CAS  PubMed  Google Scholar 

  28. Aalberse RC, Stapel SO, Schuurman J, Rispens T. Immunoglobulin G4: an odd antibody. Clin Exp Allergy. 2009;39(4):469–77.

    CAS  PubMed  Google Scholar 

  29. Arias A, Gonzalez-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):1639–48.

    PubMed  Google Scholar 

  30. Egan M, Atkins D. What is the Relationship Between Eosinophilic Esophagitis (EoE) and aeroallergens? Implications for allergen immunotherapy. Curr Allergy Asthma Rep. 2018;18(8):43.

    PubMed  PubMed Central  Google Scholar 

  31. Herrick CA, MacLeod H, Glusac E, Tigelaar RE, Bottomly K. Th2 responses induced by epicutaneous or inhalational protein exposure are differentially dependent on IL-4. J Clin Invest. 2000;105(6):765–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Jensen ET, Dellon ES. Environmental factors and eosinophilic esophagitis. J Allergy Clin Immunol. 2018;142(1):32–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Jensen ET, Kuhl JT, Martin LJ, Rothenberg ME, Dellon ES. Prenatal, intrapartum, and postnatal factors are associated with pediatric eosinophilic esophagitis. J Allergy Clin Immunol. 2018;141(1):214–22.

    PubMed  Google Scholar 

  34. Lucendo AJ, Hervias D, Roncero O, Lorente R, Bouhmidi A, Angueira T, et al. Epidemiology and temporal trends (2000–2012) of inflammatory bowel disease in adult patients in a central region of Spain. Eur J Gastroenterol Hepatol. 2014;26(12):1399–407.

    PubMed  Google Scholar 

  35. Alexander ES, Martin LJ, Collins MH, Kottyan LC, Sucharew H, He H, et al. Twin and family studies reveal strong environmental and weaker genetic cues explaining heritability of eosinophilic esophagitis. J Allergy Clin Immunol. 2014;134(5):1084–92 e1.

    PubMed  PubMed Central  Google Scholar 

  36. Kottyan LC, Rothenberg ME. Genetics of eosinophilic esophagitis. Mucosal Immunol. 2017;10(3):580–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Litosh VA, Rochman M, Rymer JK, Porollo A, Kottyan LC, Rothenberg ME. Calpain-14 and its association with eosinophilic esophagitis. J Allergy Clin Immunol. 2017;139(6):1762–71 e7.

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Sleiman PM, Wang ML, Cianferoni A, Aceves S, Gonsalves N, Nadeau K, et al. GWAS identifies four novel eosinophilic esophagitis loci. Nat Commun. 2014;5:5593.

    PubMed  Google Scholar 

  39. Sorimachi H, Hata S, Ono Y. Impact of genetic insights into calpain biology. J Biochem. 2011;150(1):23–37.

    CAS  PubMed  Google Scholar 

  40. Abonia JP, Wen T, Stucke EM, Grotjan T, Griffith MS, Kemme KA, et al. High prevalence of eosinophilic esophagitis in patients with inherited connective tissue disorders. J Allergy Clin Immunol. 2013;132(2):378–86.

    PubMed  Google Scholar 

  41. Sherrill JD, Kc K, Wang X, Wen T, Chamberlin A, Stucke EM, et al. Whole-exome sequencing uncovers oxidoreductases DHTKD1 and OGDHL as linkers between mitochondrial dysfunction and eosinophilic esophagitis. JCI Insight. 2018;3(8) https://doi.org/10.1172/jci.insight.99922.

  42. Wen T, Dellon ES, Moawad FJ, Furuta GT, Aceves SS, Rothenberg ME. Transcriptome analysis of proton pump inhibitor-responsive esophageal eosinophilia reveals proton pump inhibitor-reversible allergic inflammation. J Allergy Clin Immunol. 2015;135(1):187–97.

    CAS  PubMed  Google Scholar 

  43. Sperry SL, Woosley JT, Shaheen NJ, Dellon ES. Influence of race and gender on the presentation of eosinophilic esophagitis. Am J Gastroenterol. 2012;107(2):215–21.

    PubMed  Google Scholar 

  44. Sperry SL, Crockett SD, Miller CB, Shaheen NJ, Dellon ES. Esophageal foreign-body impactions: epidemiology, time trends, and the impact of the increasing prevalence of eosinophilic esophagitis. Gastrointest Endosc. 2011;74(5):985–91.

    PubMed  PubMed Central  Google Scholar 

  45. Almansa C, Krishna M, Buchner AM, Ghabril MS, Talley N, DeVault KR, et al. Seasonal distribution in newly diagnosed cases of eosinophilic esophagitis in adults. Am J Gastroenterol. 2009;104(4):828–33.

    PubMed  Google Scholar 

  46. Chehade M. IgE and non-IgE-mediated food allergy: treatment in 2007. Curr Opin Allergy Clin Immunol. 2007;7(3):264–8.

    CAS  PubMed  Google Scholar 

  47. Hiremath G, Byramji D, Pacheco A, Constantine G, Davis C, Shulman R, et al. Eosinophilic esophagitis in children and its relationship with parental allergies: Texas Children’s Hospital experience. Dig Dis Sci. 2016;61(2):501–6.

    Google Scholar 

  48. Dellon ES, Liacouras CA, Molina-Infante J, Furuta GT, Spergel JM, Zevit N, et al. Updated international consensus diagnostic criteria for eosinophilic esophagitis: proceedings of the AGREE conference. Gastroenterology. 2018;155(4):1022–1033.e10. https://doi.org/10.1053/j.gastro.2018.07.009.

    Article  PubMed  Google Scholar 

  49. Wechsler JB, Bolton SM, Amsden K, Wershil BK, Hirano I, Kagalwalla AF. Eosinophilic esophagitis reference score accurately identifies disease activity and treatment effects in children. Clin Gastroenterol Hepatol. 2018;16(7):1056–63.

    PubMed  Google Scholar 

  50. Nielsen JA, Lager DJ, Lewin M, Rendon G, Roberts CA. The optimal number of biopsy fragments to establish a morphologic diagnosis of eosinophilic esophagitis. Am J Gastroenterol. 2014;109(4):515–20.

    PubMed  Google Scholar 

  51. Gonsalves N, Policarpio-Nicolas M, Zhang Q, Rao MS, Hirano I. Histopathologic variability and endoscopic correlates in adults with eosinophilic esophagitis. Gastrointest Endosc. 2006;64(3):313–9.

    PubMed  Google Scholar 

  52. Sperry SL, Shaheen NJ, Dellon ES. Toward uniformity in the diagnosis of eosinophilic esophagitis (EoE): the effect of guidelines on variability of diagnostic criteria for EoE. Am J Gastroenterol. 2011;106(5):824–32; quiz 33

    PubMed  Google Scholar 

  53. Collins MH. Histopathologic features of eosinophilic esophagitis and eosinophilic gastrointestinal diseases. Gastroenterol Clin North Am. 2014;43(2):257–68.

    PubMed  Google Scholar 

  54. Collins MH, Martin LJ, Alexander ES, Boyd JT, Sheridan R, He H, et al. Newly developed and validated eosinophilic esophagitis histology scoring system and evidence that it outperforms peak eosinophil count for disease diagnosis and monitoring. Dis Esophagus. 2017;30(3):1–8.

    CAS  PubMed  Google Scholar 

  55. Kia L, Hirano I. Distinguishing GERD from eosinophilic oesophagitis: concepts and controversies. Nat Rev Gastroenterol Hepatol. 2015;12(7):379–86.

    CAS  PubMed  PubMed Central  Google Scholar 

  56. Furuta GT, Kagalwalla AF, Lee JJ, Alumkal P, Maybruck BT, Fillon S, et al. The oesophageal string test: a novel, minimally invasive method measures mucosal inflammation in eosinophilic oesophagitis. Gut. 2013;62(10):1395–405.

    CAS  PubMed  Google Scholar 

  57. Katzka DA, Geno DM, Ravi A, Smyrk TC, Lao-Sirieix P, Miremadi A, et al. Accuracy, safety, and tolerability of tissue collection by Cytosponge vs endoscopy for evaluation of eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2015;13(1):77–83 e2.

    PubMed  Google Scholar 

  58. Friedlander JA, DeBoer EM, Soden JS, Furuta GT, Menard-Katcher CD, Atkins D, et al. Unsedated transnasal esophagoscopy for monitoring therapy in pediatric eosinophilic esophagitis. Gastrointest Endosc. 2016;83(2):299–306 e1.

    PubMed  Google Scholar 

  59. Fox VL, Nurko S, Teitelbaum JE, Badizadegan K, Furuta GT. High-resolution EUS in children with eosinophilic “allergic” esophagitis. Gastrointest Endosc. 2003;57(1):30–6.

    PubMed  Google Scholar 

  60. Nicodeme F, Hirano I, Chen J, Robinson K, Lin Z, Xiao Y, et al. Esophageal distensibility as a measure of disease severity in patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2013;11(9):1101–7 e1.

    PubMed  PubMed Central  Google Scholar 

  61. Mulder DJ, Hookey LC, Hurlbut DJ, Justinich CJ. Impact of Crohn disease on eosinophilic esophagitis: evidence for an altered T(H)1-T(H)2 immune response. J Pediatr Gastroenterol Nutr. 2011;53(2):213–5.

    PubMed  Google Scholar 

  62. Ludvigsson JF, Aro P, Walker MM, Vieth M, Agreus L, Talley NJ, et al. Celiac disease, eosinophilic esophagitis and gastroesophageal reflux disease, an adult population-based study. Scand J Gastroenterol. 2013;48(7):808–14.

    PubMed  PubMed Central  Google Scholar 

  63. Chan LJ, Tan L, Dhaliwal J, Briglia F, Clarkson C, Krishnan U. Treatment outcomes for eosinophilic esophagitis in children with esophageal atresia. Dis Esophagus. 2016;29(6):563–71.

    CAS  PubMed  Google Scholar 

  64. Kassabian S, Baez-Socorro V, Sferra T, Garcia R. Eosinophilic esophagitis in patients with esophageal atresia and chronic dysphagia. World J Gastroenterol. 2014;20(47):18038–43.

    PubMed  PubMed Central  Google Scholar 

  65. Munoz-Persy M, Lucendo AJ. Treatment of eosinophilic esophagitis in the pediatric patient: an evidence-based approach. Eur J Pediatr. 2018;177(5):649–63.

    CAS  PubMed  Google Scholar 

  66. Dellon ES, Kim HP, Sperry SL, Rybnicek DA, Woosley JT, Shaheen NJ. A phenotypic analysis shows that eosinophilic esophagitis is a progressive fibrostenotic disease. Gastrointest Endosc. 2014;79(4):577–85 e4.

    PubMed  Google Scholar 

  67. Franciosi JP, Hommel KA, DeBrosse CW, Greenberg AB, Greenler AJ, Abonia JP, et al. Development of a validated patient-reported symptom metric for pediatric eosinophilic esophagitis: qualitative methods. BMC Gastroenterol. 2011;11:126.

    PubMed  PubMed Central  Google Scholar 

  68. Safroneeva E, Straumann A, Coslovsky M, Zwahlen M, Kuehni CE, Panczak R, et al. Symptoms have modest accuracy in detecting endoscopic and histologic remission in adults with eosinophilic esophagitis. Gastroenterology. 2016;150(3):581–90 e4.

    PubMed  Google Scholar 

  69. Martin LJ, Franciosi JP, Collins MH, Abonia JP, Lee JJ, Hommel KA, et al. Pediatric Eosinophilic Esophagitis Symptom Scores (PEESS v2.0) identify histologic and molecular correlates of the key clinical features of disease. J Allergy Clin Immunol. 2015;135(6):1519–28 e8.

    PubMed  PubMed Central  Google Scholar 

  70. Schneuer FJ, Bentley JP, Davidson AJ, Holland AJ, Badawi N, Martin AJ, et al. The impact of general anesthesia on child development and school performance: a population-based study. Paediatr Anaesth. 2018;28(6):528–36.

    PubMed  Google Scholar 

  71. Shah A, Kagalwalla AF, Gonsalves N, Melin-Aldana H, Li BU, Hirano I. Histopathologic variability in children with eosinophilic esophagitis. Am J Gastroenterol. 2009;104(3):716–21.

    PubMed  Google Scholar 

  72. Lucendo AJ, Arias A, Molina-Infante J. Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2016;14(1):13–22 e1.

    CAS  PubMed  Google Scholar 

  73. Gutierrez-Junquera C, Fernandez-Fernandez S, Cilleruelo ML, Rayo A, Echeverria L, Borrell B, et al. Long-term treatment with proton pump inhibitors is effective in children with eosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2018 Aug;67(2):210–6.

    CAS  PubMed  Google Scholar 

  74. Molina-Infante J, Bredenoord AJ, Cheng E, Dellon ES, Furuta GT, Gupta SK, et al. Proton pump inhibitor-responsive oesophageal eosinophilia: an entity challenging current diagnostic criteria for eosinophilic oesophagitis. Gut. 2016;65(3):524–31.

    CAS  PubMed  Google Scholar 

  75. Tjon JA, Pe M, Soscia J, Mahant S. Efficacy and safety of proton pump inhibitors in the management of pediatric gastroesophageal reflux disease. Pharmacotherapy. 2013;33(9):956–71.

    CAS  PubMed  Google Scholar 

  76. Peterson KA, Byrne KR, Vinson LA, Ying J, Boynton KK, Fang JC, et al. Elemental diet induces histologic response in adult eosinophilic esophagitis. Am J Gastroenterol. 2013;108(5):759–66.

    CAS  PubMed  Google Scholar 

  77. Schaefer ET, Fitzgerald JF, Molleston JP, Croffie JM, Pfefferkorn MD, Corkins MR, et al. Comparison of oral prednisone and topical fluticasone in the treatment of eosinophilic esophagitis: a randomized trial in children. Clin Gastroenterol Hepatol. 2008;6(2):165–73.

    CAS  PubMed  Google Scholar 

  78. Konikoff MR, Noel RJ, Blanchard C, Kirby C, Jameson SC, Buckmeier BK, et al. A randomized, double-blind, placebo-controlled trial of fluticasone propionate for pediatric eosinophilic esophagitis. Gastroenterology. 2006;131(5):1381–91.

    CAS  PubMed  Google Scholar 

  79. Hsu S, Wood C, Pan Z, Rahat H, Zeitler P, Fleischer D, et al. Adrenal insufficiency in pediatric eosinophilic esophagitis patients treated with swallowed topical steroids. Pediatr Allergy Immunol Pulmonol. 2017;30(3):135–40.

    PubMed  PubMed Central  Google Scholar 

  80. Andreae DA, Hanna MG, Magid MS, Malerba S, Andreae MH, Bagiella E, et al. Swallowed fluticasone propionate is an effective long-term maintenance therapy for children with eosinophilic esophagitis. Am J Gastroenterol. 2016;111(8):1187–97.

    CAS  PubMed  PubMed Central  Google Scholar 

  81. Dellon ES, Sheikh A, Speck O, Woodward K, Whitlow AB, Hores JM, et al. Viscous topical is more effective than nebulized steroid therapy for patients with eosinophilic esophagitis. Gastroenterology. 2012;143(2):321–4 e1.

    CAS  PubMed  Google Scholar 

  82. Constantine G, Seth N, Chokshi N, Minard CG, Guffey D, Olive AP, et al. Combination steroid and test-based food elimination for eosinophilic esophagitis: a retrospective analysis. J Pediatr Gastroenterol Nutr. 2017;64(6):933–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  83. Netzer P, Gschossmann JM, Straumann A, Sendensky A, Weimann R, Schoepfer AM. Corticosteroid-dependent eosinophilic oesophagitis: azathioprine and 6-mercaptopurine can induce and maintain long-term remission. Eur J Gastroenterol Hepatol. 2007;19(10):865–9.

    CAS  PubMed  Google Scholar 

  84. Assa’ad AH, Gupta SK, Collins MH, Thomson M, Heath AT, Smith DA, et al. An antibody against IL-5 reduces numbers of esophageal intraepithelial eosinophils in children with eosinophilic esophagitis. Gastroenterology. 2011;141(5):1593–604.

    PubMed  Google Scholar 

  85. Lucendo AJ, Molina-Infante J. Emerging therapeutic strategies for eosinophilic esophagitis. Curr Treat Options Gastroenterol. 2014;12(1):1–17.

    PubMed  Google Scholar 

  86. Lipka S, Kumar A, Richter JE. Impact of diagnostic delay and other risk factors on eosinophilic esophagitis phenotype and esophageal diameter. J Clin Gastroenterol. 2016;50(2):134–40.

    CAS  PubMed  Google Scholar 

  87. van Rhijn BD, Oors JM, Smout AJ, Bredenoord AJ. Prevalence of esophageal motility abnormalities increases with longer disease duration in adult patients with eosinophilic esophagitis. Neurogastroenterol Motil. 2014;26(9):1349–55.

    PubMed  Google Scholar 

  88. Moawad FJ, Molina-Infante J, Lucendo AJ, Cantrell SE, Tmanova L, Douglas KM. Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis. Aliment Pharmacol Ther. 2017;46(2):96–105.

    CAS  PubMed  Google Scholar 

  89. Franciosi JP, Hommel KA, Bendo CB, King EC, Collins MH, Eby MD, et al. PedsQL eosinophilic esophagitis module: feasibility, reliability, and validity. J Pediatr Gastroenterol Nutr. 2013;57(1):57–66.

    PubMed  PubMed Central  Google Scholar 

  90. Klinnert MD, Silveira L, Harris R, Moore W, Atkins D, Fleischer DM, et al. Health-related quality of life over time in children with eosinophilic esophagitis and their families. J Pediatr Gastroenterol Nutr. 2014;59(3):308–16.

    PubMed  PubMed Central  Google Scholar 

  91. Lynch MK, Barnes MJ, Dimmitt RA, Martin L, Rothenberg ME, Goodin BR. Disease-related predictors of health-related quality of life in youth with eosinophilic esophagitis. J Pediatr Psychol. 2018;43(4):464–71.

    PubMed  Google Scholar 

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Perez, C., Olive, A., Davis, C.M. (2020). Eosinophilic Esophagitis. In: Gupta, R. (eds) Pediatric Food Allergy . Springer, Cham. https://doi.org/10.1007/978-3-030-33292-1_8

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