Suddenly, I'm not able to keep up with all the EGID-related articles being published! This is really a great thing, because that means that EGIDs are getting more attention by the medical community. Here are some recent abstracts:
Eosinophilic and lymphocytic colitis: different histological manifestations of a same process in patients with chronic diarrhea
Conclusion: 3 out of 4 patients with LC (lymphocytic colitis)
had elevated eosinophils and 1 of 2 patients with LC had criteria for EC (eosinophilic colitis)
.
http://www.ncbi.nlm.nih.gov/pubmed/23539055
Incidence and Prevalence of Eosinophilic Esophagitis in Children: Systematic Review and Meta-Analysis.
http://www.ncbi.nlm.nih.gov/pubmed/23539047
Selective IgA deficiency mimicking Churg-Strauss syndrome and hypereosinophilic syndrome: a case report.
http://www.ncbi.nlm.nih.gov/pubmed/23544278
Emerging concepts of dietary therapy for pediatric and adult eosinophilic esophagitis (This is a free, full text PDF file.)
Overall conclusions that can be drawn from these studies include: the elemental diet is superior to the SFED and skin test-directed diet; the SFED is similar to skin test-directed diet therapy in response rate and nearly similar in the number of foods eliminated in pediatric EoE; and the SFED is an effective therapy in adult EoE.
Food reintroduction order after SFED, for:
children:
seafood/nuts, soy, wheat, egg, milk (suggesting that egg and milk are the most common triggers for children)
adults: seafood, egg, nuts/soy, milk, wheat (milk and wheat being the most common triggers for adults)
http://www.expert-reviews.com/doi/pdfplus/10.1586/eci.13.15
Eosinophilic Esophagitis: Update on Pathophysiology and Management
This is a PDF slideshow aimed at medical professionals. One interesting slide shows that the 2 most effective elimination diets (showing a much higher success rate than SFED) were either:
1. milk, egg, wheat, soy, meats
2. allergy testing directed + milk
50-60% of patients with EoE have a prior history of atopy
15-43% of EoE patients have IgE-mediated immediate food hypersensitivity
In children with EoE, 40-75% have allergic rhinitis, 14-70% asthma, 4-60% eczema
There is also an interesting slide with pictures of the genetic changes in EoE, and there are some labeled "sporadic EoE" and some labeled "familial EoE". That's the first I've seen that distinction.
http://www.newenglandsocietyofallergy.org/2013%2520Spring%2520Meeting/EoE_path_and_management.pdf&ct=ga&cad=CAcQAhgAIAEoBDAAOABAw8WGiwVIAVgAYgVlbi1VUw&cd=HevxJE7x8lM&usg=AFQjCNHZNX1hNtEGgRuWmAv1lXIME6MA6Q
ACG Clinical Guideline: Evidenced Based Approach to the Diagnosis
and Management of Esophageal Eosinophilia and Eosinophilic Esophagitis
(EoE).
http://www.ncbi.nlm.nih.gov/pubmed/23567357
Eosinophilic esophagitis: an immune-mediated esophageal disease.
http://www.ncbi.nlm.nih.gov/pubmed/23579771
Do endoscopic features suggesting eosinophilic esophagitis represent histological eosinophilia?
CONCLUSIONS:An endoscopic feature suggesting EoE does not
always represent esophageal eosinophilia and is non-specific for EoE,
although it reminds endoscopists of the presence of EoE. The diagnostic
utility of linear furrows or corrugated rings for esophageal
eosinophilia is superior to that of white exudates.
http://www.ncbi.nlm.nih.gov/pubmed/23581603
Esophageal Distensibility as a Measure of Disease Severity in Patients with Eosinophilic Esophagitis.
CONCLUSIONS:Reduced esophageal distensibility predicts risk
for food impaction and the requirement for esophageal dilation in
patients with eosinophilic esophagitis. The severity of mucosal
eosinophilia was not predictive of these outcomes and had a poor
correlation with esophageal distensibility.
http://www.ncbi.nlm.nih.gov/pubmed/23591279
Pathogenic role of mast cells in experimental eosinophilic esophagitis.
http://www.ncbi.nlm.nih.gov/pubmed/23599040
Atopic and non-atopic eosinophilic oesophagitis are distinguished by immunoglobulin E-bearing intraepithelial mast cells.
IgE-bearing mast cells are increased in atopic EoE patients but not in non-atopic EoE patients.
http://www.ncbi.nlm.nih.gov/pubmed/22978418
