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Eosinophilic Gastroenteropathy

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Textbook of Pediatric Gastroenterology, Hepatology and Nutrition

Abstract

Eosinophilic gastroenteritis (EGE) is a clinicopathological disorder characterized by a dense eosinophilic inflammation in one or more segments of the digestive tract. First described more than 70 years ago, this disorder has become the subject of increased interest because of the rapidly growing number of new cases. It has been observed in patients of all ages, who are diagnosed with the aid of endoscopic testing after seeking medical help for abdominal pain, vomiting, diarrhea, or weight loss. Even with this increased interest, however, many aspects of the disease remain unclear, including its epidemiology, physiopathology, and prognosis. Moreover, common diagnostic criteria have yet to be established, although current histological indications for EGE include the presence of an infiltration of > 30 eosinophils per high-power field (hpf) in at least 5 hpfs, signs of eosinophilic degranulation, and extension to the muscularis mucosae or submucosa. From a clinical point of view, EGE has traditionally been classified into three forms depending on the depth of inflammation in the gastrointestinal (GI) wall (mucosal, submucosal, and serosal). This, together with the digestive tract segments involved, determines the clinical presentation, although cases of EGE with biliopancreatic involvement have been also described.

With regard to treatment and management of EGE patients, no consensual algorithms are available, mostly because the low prevalence of the disease has hindered the performance of comparative trials. Corticosteroids remain the most frequently used treatment, although some studies have shown other antiallergic drugs to have beneficial effects. A new focus in EGE management is dietary treatment, which should be considered especially in younger patients. Finally, surgery is often used as a last resort to solve complications such as strictures and small-bowel perforation.

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  1. Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain

    Alfredo J. Lucendo

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  1. Department of Pediatrics, University of Chicago, Chicago, Illinois, USA

    Stefano Guandalini

  2. Clinical Director Child Health King’s College Hospital, Professor and Director Pediatric Liver, GI and Nutrition Center, London, United Kingdom

    Anil Dhawan

  3. Department of Pediatrics, Hebrew University Hadassah Hospital, Jerusalem, Israel

    David Branski

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Lucendo, A. (2016). Eosinophilic Gastroenteropathy. In: Guandalini, S., Dhawan, A., Branski, D. (eds) Textbook of Pediatric Gastroenterology, Hepatology and Nutrition. Springer, Cham. https://doi.org/10.1007/978-3-319-17169-2_27

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