小儿嗜酸性食管炎的管理指南
授权机构:European Society for Pediatric Gastroenterology, Hepatology, and Nutrition 欧洲儿科胃肠病、肝脏病与营养协会
Eosinophilic esophagitis (EoE) is a chronic immune/antigenmediated esophageal inflammatory disease associated with esophageal dysfunction resulting from severe eosinophil-predominant inflammation. In 2007, a multidisciplinary group of experts published the first consensus recommendations for the diagnosis and treatment of EoE (1), which were recently updated. The updated definition of the disease includes the histological presence of 15 eosinophils per high power field (eos/hpf) in at least 1 endoscopic esophageal mucosal biopsy (peak value) taken at upper gastrointestinal endoscopy; and/or the presence of other microscopic features of eosinophilic inflammation such as eosinophilic microabscesses, superficial layering, or extracellular eosinophil granules. These publications provide extensive information on pathogenesis, epidemiology, clinical presentation, diagnosis, and management of EoE in both adults and children; however, a practical algorithm on the optimal treatment of children with EoE, to guide clinical practice, is lacking. This position paper of the Eosinophilic Esophagitis Working Group (see Appendix) and the Gastroenterology Committee of ESPGHAN aims at providing practical guidelines for the management of children and adolescents with EoE, based on available evidence where possible. If sufficient evidence is lacking, our recommendations are based on expert opinion and personal practice.
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