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Copyright ©2012 Baishideng. All rights reserved.
World J Gastrointest Endosc. Aug 16, 2012; 4(8): 347-355
Published online Aug 16, 2012. doi: 10.4253/wjge.v4.i8.347
Contribution of endoscopy in the management of eosinophilic esophagitis
Cristina Targa Ferreira, Helena AS Goldani
Cristina Targa Ferreira, Helena AS Goldani, Department of Pediatrics and Gastroenterology Unit, Hospital de Clinicas de Porto Alegre, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, 90430-140 Porto Alegre, RS, Brazil
Author contributions: Both authors reviewed the literature and wrote the manuscript.
Correspondence to: Cristina Targa Ferreira, MD, PhD, Department of Pediatrics and Gastroenterology Unit, Hospital de Clinicas de Porto Alegre, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Pedro Weingartner 105/202, 90430-140 Porto Alegre, RS, Brazil. cristinatarga@terra.com.br
Telephone: +55-51-33313295 Fax: +55-51-33884369
Received: October 14, 2011
Revised: February 27, 2012
Accepted: August 8, 2012
Published online: August 16, 2012
Abstract

Eosinophilic esophagitis (EoE) is a clinicopathological entity characterized by a set of symptoms similar to gastroesophageal reflux disease and eosinophilic infiltration of the esophageal epithelium. EoE is an emerging worldwide disease as documented in many countries. Recent reports indicate that EoE is increasingly diagnosed in both pediatric and adult patients although the epidemiology of this new disease entity remains unclear. It is unclear whether EoE is a new disease or a new classification of an old esophageal disorder. Esophagogastroduodenoscopy (EGD) and biopsies with histological examination of esophageal mucosa are required to establish the diagnosis of EoE, verify response to therapy, assess disease remission, document and dilate strictures and evaluate symptom recurrence of EoE. Repeated endoscopies with biopsies are necessary for monitoring of disease progression and treatment efficacy. EGD has a fundamental role in the diagnosis and management of EoE, forming an essential part of the investigation and follow-up of this condition. EoE is now considered a systemic disorder and not only a local condition with an important immunological background. One of the aims of research in EoE is to study non-invasive markers, such as immune indicators found in plasma, that correlate with local presence of EoE in esophageal tissues. Studies over the next few years will provide new information about diagnosis, pathogenesis, endoscopic/histologic criteria, non-invasive markers, novel and more efficacious treatments, as well as establishing natural history. Randomized clinical trials are urgently called for to inform non-invasive diagnostic tests, hallmarks of natural history and more efficacious treatment approaches for patients with EoE. The collaboration between pediatric and adult clinical and experimental studies will be paramount in the understanding and management of this disease.

Keywords: Eosinophilic; Esophagitis; Atopy; Endoscopy; Pediatrics