Pediatric and adult eosinophilic esophagitis: Similarities and differences

A. Straumann*, S. S. Aceves, C. Blanchard, M. H. Collins, G. T. Furuta, I. Hirano, A. M. Schoepfer, D. Simon, H. U. Simon

*Corresponding author for this work

Research output: Contribution to journalReview article

161 Scopus citations

Abstract

Early in the 1990s, several case series described adults suffering from dysphagia and children with refractory reflux symptoms, both accompanied by an eosinophil-predominant infiltration, thereby conclusively distinguishing it from gastroesophageal reflux disease. Eosinophilic esophagitis (EoE) was recognized as its own entity in the adult and in the pediatric literature. In the last decade, evidence has accumulated that EoE represents a T-helper (Th)2-type inflammatory disease. Remodeling of the esophagus is a hallmark of EoE, leading to esophageal dysfunction and bolus impaction. Familial occurrence and disease association with single-nucleotide polymorphisms underscore the influence of genetics in this disease. Eosinophilic esophagitis may affect individuals at any age, although the clinical presentation is highly age dependent. There is a significant allergic bias in the EoE population, with the majority of patients having concurrent allergic rhinitis, asthma, eczema, and/or a history of atopy. One noteworthy difference is that in children, EoE seems to be primarily a food antigen-driven disease, whereas in adults, mainly aeroallergen sensitization has been observed. Treatment modalities for EoE include the 3Ds: drugs, diet, and dilation. The crucial question of whether adult and pediatric EoE are different phenotypes of one single entity or whether we are confronted with two different diseases is still open. Here, we review similarities and differences between EoE in adults and children.

Original languageEnglish (US)
Pages (from-to)477-490
Number of pages14
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume67
Issue number4
DOIs
StatePublished - Apr 2012

Keywords

  • Th2-type inflammation
  • corticosteroids
  • diet
  • dysphagia
  • eosinophilic esophagitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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    Straumann, A., Aceves, S. S., Blanchard, C., Collins, M. H., Furuta, G. T., Hirano, I., Schoepfer, A. M., Simon, D., & Simon, H. U. (2012). Pediatric and adult eosinophilic esophagitis: Similarities and differences. Allergy: European Journal of Allergy and Clinical Immunology, 67(4), 477-490. https://doi.org/10.1111/j.1398-9995.2012.02787.x