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Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference.
Dellon, Evan S; Liacouras, Chris A; Molina-Infante, Javier; Furuta, Glenn T; Spergel, Jonathan M; Zevit, Noam; Spechler, Stuart J; Attwood, Stephen E; Straumann, Alex; Aceves, Seema S; Alexander, Jeffrey A; Atkins, Dan; Arva, Nicoleta C; Blanchard, Carine; Bonis, Peter A; Book, Wendy M; Capocelli, Kelley E; Chehade, Mirna; Cheng, Edaire; Collins, Margaret H; Davis, Carla M; Dias, Jorge A; Di Lorenzo, Carlo; Dohil, Ranjan; Dupont, Christophe; Falk, Gary W; Ferreira, Cristina T; Fox, Adam; Gonsalves, Nirmala P; Gupta, Sandeep K; Katzka, David A; Kinoshita, Yoshikazu; Menard-Katcher, Calies; Kodroff, Ellyn; Metz, David C; Miehlke, Stephan; Muir, Amanda B; Mukkada, Vincent A; Murch, Simon; Nurko, Samuel; Ohtsuka, Yoshikazu; Orel, Rok; Papadopoulou, Alexandra; Peterson, Kathryn A; Philpott, Hamish; Putnam, Philip E; Richter, Joel E; Rosen, Rachel; Rothenberg, Marc E; Schoepfer, Alain.
Afiliación
  • Dellon ES; Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. Electronic address: edellon@med.unc.edu.
  • Liacouras CA; Center for Pediatric Eosinophilic Diseases, Division of Gastroenterology and Hepatology & Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
  • Molina-Infante J; Department of Gastroenterology, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain and Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
  • Furuta GT; Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado and Gastrointestinal Eosinophilic Diseases Program, University of Colorado School of Medicine, Aurora, Colorado.
  • Spergel JM; Center for Pediatric Eosinophilic Diseases, Division of Allergy-Immunology, The Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania.
  • Zevit N; Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
  • Spechler SJ; Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas.
  • Attwood SE; Department of Health Services Research, Durham University, Durham, UK.
  • Straumann A; Swiss EoE Research Network, Olten, Switzerland.
  • Aceves SS; Division of Allergy, Immunology, Departments of Pediatrics and Medicine, University of California-San Diego and Rady Children's Hospital, San Diego, La Jolla, California.
  • Alexander JA; Division of Gastroenterology, Mayo Clinic, Rochester, Minnesota.
  • Atkins D; Allergy & Immunology Section, Children's Hospital Colorado and Gastrointestinal Eosinophilic Diseases Program, University of Colorado School of Medicine, Aurora, Colorado.
  • Arva NC; Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
  • Blanchard C; Institute of Nutritional Science, Nestlé Research Center, Vevey, Switzerland.
  • Bonis PA; Division of Gastroenterology, Tufts University School of Medicine, Boston, Massachusetts.
  • Book WM; American Partnership for Eosinophilic Disorders, Atlanta, Georgia.
  • Capocelli KE; Department of Pediatric Pathology, Children's Hospital Colorado, Aurora, Colorado.
  • Chehade M; Mount Sinai Center for Eosinophilic Disorders, Icahn School of Medicine at Mount Sinai, New York, New York.
  • Cheng E; Departments of Pediatrics and Internal Medicine, Children's Medical Center, University of Texas Southwestern Medical Center, Dallas, Texas.
  • Collins MH; Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • Davis CM; Allergy and Immunology Section of the Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
  • Dias JA; Pediatric Gastroenterology, Centro Hospitalar S. João, Porto, Portugal.
  • Di Lorenzo C; Division of Gastroenterology and Hepatology & Nutrition, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.
  • Dohil R; Division of Gastroenterology and Hepatology, University of California-San Diego, Rady Children's Hospital, San Diego, California.
  • Dupont C; Necker Hospital, Paris-Descartes University, Paris, France.
  • Falk GW; Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
  • Ferreira CT; Federal University of Health Sciences of Porto Alegre, Hospital Santo Antônio, Porto Alegre, RS, Brazil.
  • Fox A; Department of Paediatric Allergy, Guy's & St Thomas' Hospitals NHS Foundation Trust, London, UK.
  • Gonsalves NP; Division of Gastroenterology and Hepatology, Northwestern University-Feinberg School of Medicine, Chicago, Illinois.
  • Gupta SK; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Illinois, University of Illinois, Peoria, Illinois.
  • Katzka DA; Division of Gastroenterology, Mayo Clinic, Rochester, Minnesota.
  • Kinoshita Y; Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
  • Menard-Katcher C; Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado and Gastrointestinal Eosinophilic Diseases Program, University of Colorado School of Medicine, Aurora, Colorado.
  • Kodroff E; Campaign Urging Research for Eosinophilic Diseases, Lincolnshire, Illinois.
  • Metz DC; Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
  • Miehlke S; Centre for Digestive Diseases, Internal Medicine Center, Eppendorf, Hamburg, Germany.
  • Muir AB; Center for Pediatric Eosinophilic Diseases, Division of Gastroenterology and Hepatology & Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
  • Mukkada VA; Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • Murch S; Department of Paediatrics, University Hospital Coventry & Warwickshire, Coventry, UK.
  • Nurko S; Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Boston, Massachusetts.
  • Ohtsuka Y; Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
  • Orel R; University of Ljubljana, Faculty of Medicine, University Children's Hospital, Ljubljana, Slovenia.
  • Papadopoulou A; Division of Gastroenterology and Hepatology, First Department of Pediatrics, University of Athens, Children's Hospital Agia Sofia, Athens, Greece.
  • Peterson KA; University of Utah, Salt Lake City, Utah.
  • Philpott H; Northern Adelaide Local Health Network, Department of Gastroenterology, University of Adelaide, South Australia.
  • Putnam PE; Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • Richter JE; University of South Florida Morsani College of Medicine, Tampa, Florida.
  • Rosen R; Aerodigestive Center, Boston Children's Hospital, Boston, Massachusetts.
  • Rothenberg ME; Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • Schoepfer A; Division of Gastroenterology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Gastroenterology ; 155(4): 1022-1033.e10, 2018 10.
Article en En | MEDLINE | ID: mdl-30009819
BACKGROUND & AIMS: Over the last decade, clinical experiences and research studies raised concerns regarding use of proton pump inhibitors (PPIs) as part of the diagnostic strategy for eosinophilic esophagitis (EoE). We aimed to clarify the use of PPIs in the evaluation and treatment of children and adults with suspected EoE to develop updated international consensus criteria for EoE diagnosis. METHODS: A consensus conference was convened to address the issue of PPI use for esophageal eosinophilia using a process consistent with standards described in the Appraisal of Guidelines for Research and Evaluation II. Pediatric and adult physicians and researchers from gastroenterology, allergy, and pathology subspecialties representing 14 countries used online communications, teleconferences, and a face-to-face meeting to review the literature and clinical experiences. RESULTS: Substantial evidence documented that PPIs reduce esophageal eosinophilia in children, adolescents, and adults, with several mechanisms potentially explaining the treatment effect. Based on these findings, an updated diagnostic algorithm for EoE was developed, with removal of the PPI trial requirement. CONCLUSIONS: EoE should be diagnosed when there are symptoms of esophageal dysfunction and at least 15 eosinophils per high-power field (or approximately 60 eosinophils per mm2) on esophageal biopsy and after a comprehensive assessment of non-EoE disorders that could cause or potentially contribute to esophageal eosinophilia. The evidence suggests that PPIs are better classified as a treatment for esophageal eosinophilia that may be due to EoE than as a diagnostic criterion, and we have developed updated consensus criteria for EoE that reflect this change.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Técnicas de Diagnóstico del Sistema Digestivo / Inhibidores de la Bomba de Protones / Esofagitis Eosinofílica / Gastroenterología Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: Gastroenterology Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Técnicas de Diagnóstico del Sistema Digestivo / Inhibidores de la Bomba de Protones / Esofagitis Eosinofílica / Gastroenterología Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: Gastroenterology Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos