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Eosinophilic infiltration of the esophagus

MedGen UID:
1637185
Concept ID:
C4703646
Finding
Synonym: Eosinophilic esophagitis
 
HPO: HP:0410151

Definition

Infiltration of numerous eosinophils (usually greater than 15 per high power field) into the squamous epithelium of the esophagus, and layering of eosinophils on the surface layer of the esophagus. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEosinophilic infiltration of the esophagus

Conditions with this feature

Loeys-Dietz syndrome 2
MedGen UID:
382398
Concept ID:
C2674574
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Aneurysm-osteoarthritis syndrome
MedGen UID:
462437
Concept ID:
C3151087
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Loeys-Dietz syndrome 4
MedGen UID:
766676
Concept ID:
C3553762
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Severe dermatitis-multiple allergies-metabolic wasting syndrome
MedGen UID:
816049
Concept ID:
C3809719
Disease or Syndrome
A rare genetic epidermal disorder with characteristics of congenital erythroderma with severe psoriasiform dermatitis, ichthyosis, severe palmoplantar keratoderma, yellow keratosis on the hands and feet, elevated immunoglobulin E, multiple food allergies, and metabolic wasting. Other variable features may include hypotrichosis, nail dystrophy, recurrent infections, mild global developmental delay, eosinophilia, nystagmus, growth impairment and cardiac defects.
Rienhoff syndrome
MedGen UID:
816342
Concept ID:
C3810012
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Loeys-Dietz syndrome 1
MedGen UID:
1646567
Concept ID:
C4551955
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Hyper-IgE recurrent infection syndrome 1, autosomal dominant
MedGen UID:
1648470
Concept ID:
C4721531
Disease or Syndrome
STAT3 hyper IgE syndrome (STAT3-HIES) is a primary immune deficiency syndrome characterized by elevated serum IgE, eczema, and recurrent skin and respiratory tract infections, together with several nonimmune features. This disorder typically manifests in the newborn period with a rash (often diagnosed as eosinophilic pustulosis) that subsequently evolves into an eczematoid dermatitis. Recurrent staphylococcal skin boils and bacterial pneumonias usually manifest in the first years of life. Pneumatoceles and bronchiectasis often result from aberrant healing of pneumonias. Mucocutaneous candidiasis is common. Nonimmune features may include retained primary teeth, scoliosis, bone fractures following minimal trauma, joint hyperextensibility, and characteristic facial appearance, which typically emerges in adolescence. Vascular abnormalities have been described and include middle-sized artery tortuosity and aneurysms, with infrequent clinical sequelae of myocardial infarction and subarachnoid hemorrhage. Gastrointestinal (GI) manifestations include gastroesophageal reflux disease, esophageal dysmotility, and spontaneous intestinal perforations (some of which are associated with diverticuli). Fungal infections of the GI tract (typically histoplasmosis, Cryptococcus, and Coccidioides) also occur infrequently. Survival is typically into adulthood, with most individuals now living into or past the sixth decade. Most deaths are associated with gram-negative (Pseudomonas) or filamentous fungal pneumonias resulting in hemoptysis. Lymphomas occur at an increased frequency.
Combined immunodeficiency due to DOCK8 deficiency
MedGen UID:
1648410
Concept ID:
C4722305
Disease or Syndrome
Hyper-IgE syndrome-2 with recurrent infections (HIES2) is an autosomal recessive immunologic disorder characterized by recurrent staphylococcal infections of the skin and respiratory tract, eczema, elevated serum immunoglobulin E, and hypereosinophilia. It is distinguished from autosomal dominant HIES1 (147060) by the lack of connective tissue and skeletal involvement (Renner et al., 2004). For a discussion of genetic heterogeneity of hyper-IgE syndrome, see 147060. See also TYK2 deficiency (611521), a clinically distinct disease entity that includes characteristic features of both autosomal recessive HIES2 and mendelian susceptibility to mycobacterial disease (MSMD; 209950) (Minegishi et al., 2006).
Inflammatory bowel disease, immunodeficiency, and encephalopathy
MedGen UID:
1648434
Concept ID:
C4748708
Disease or Syndrome
A rare genetic disease characterized by infantile onset of severe inflammatory bowel disease manifesting with bloody diarrhea and failure to thrive, and central nervous system disease with global developmental delay and regression, impaired speech, hypotonia, hyperreflexia, and epilepsy. Brain imaging shows global cerebral atrophy, thin corpus callosum, delayed myelination, and posterior leukoencephalopathy. Cases with recurrent infections and impaired T-cell responses to stimulation, as well as decreased T-cell subsets, have been reported.

Professional guidelines

PubMed

Fernandez-Becker NQ
Gastroenterol Clin North Am 2021 Dec;50(4):825-841. Epub 2021 Oct 6 doi: 10.1016/j.gtc.2021.08.001. PMID: 34717873
Vinit C, Dieme A, Courbage S, Dehaine C, Dufeu CM, Jacquemot S, Lajus M, Montigny L, Payen E, Yang DD, Dupont C
Arch Pediatr 2019 Apr;26(3):182-190. Epub 2019 Mar 1 doi: 10.1016/j.arcped.2019.02.005. PMID: 30827775
Muñoz-Mendoza D, Chapa-Rodríguez A, Bahna SL
Clin Rev Allergy Immunol 2018 Aug;55(1):7-18. doi: 10.1007/s12016-017-8663-y. PMID: 29290036

Recent clinical studies

Etiology

Licari A, Votto M, D'Auria E, Castagnoli R, Caimmi SME, Marseglia GL
Curr Pediatr Rev 2020;16(2):106-114. doi: 10.2174/1573396315666191022154432. PMID: 31642786
Hirano I, Dellon ES, Hamilton JD, Collins MH, Peterson K, Chehade M, Schoepfer AM, Safroneeva E, Rothenberg ME, Falk GW, Assouline-Dayan Y, Zhao Q, Chen Z, Swanson BN, Pirozzi G, Mannent L, Graham NMH, Akinlade B, Stahl N, Yancopoulos GD, Radin A
Gastroenterology 2020 Jan;158(1):111-122.e10. Epub 2019 Oct 5 doi: 10.1053/j.gastro.2019.09.042. PMID: 31593702
Gonsalves N
Clin Rev Allergy Immunol 2019 Oct;57(2):272-285. doi: 10.1007/s12016-019-08732-1. PMID: 30903439
Vinit C, Dieme A, Courbage S, Dehaine C, Dufeu CM, Jacquemot S, Lajus M, Montigny L, Payen E, Yang DD, Dupont C
Arch Pediatr 2019 Apr;26(3):182-190. Epub 2019 Mar 1 doi: 10.1016/j.arcped.2019.02.005. PMID: 30827775
Lucendo AJ
Scand J Gastroenterol 2010 Sep;45(9):1013-21. doi: 10.3109/00365521003690251. PMID: 20509820

Diagnosis

Licari A, Votto M, D'Auria E, Castagnoli R, Caimmi SME, Marseglia GL
Curr Pediatr Rev 2020;16(2):106-114. doi: 10.2174/1573396315666191022154432. PMID: 31642786
Gonsalves N
Clin Rev Allergy Immunol 2019 Oct;57(2):272-285. doi: 10.1007/s12016-019-08732-1. PMID: 30903439
Fahey LM, Liacouras CA
Pediatr Clin North Am 2017 Jun;64(3):475-485. doi: 10.1016/j.pcl.2017.01.009. PMID: 28502433
Chan SK, Mahmoudi M
Compr Ther 2009 Fall-Winter;35(3-4):160-6. PMID: 20043612
Moawad FJ, Veerappan GR, Wong RK
Dig Dis Sci 2009 Sep;54(9):1818-28. Epub 2009 Jun 25 doi: 10.1007/s10620-009-0873-6. PMID: 19554448

Therapy

Hirano I, Dellon ES, Hamilton JD, Collins MH, Peterson K, Chehade M, Schoepfer AM, Safroneeva E, Rothenberg ME, Falk GW, Assouline-Dayan Y, Zhao Q, Chen Z, Swanson BN, Pirozzi G, Mannent L, Graham NMH, Akinlade B, Stahl N, Yancopoulos GD, Radin A
Gastroenterology 2020 Jan;158(1):111-122.e10. Epub 2019 Oct 5 doi: 10.1053/j.gastro.2019.09.042. PMID: 31593702
Gonsalves N
Clin Rev Allergy Immunol 2019 Oct;57(2):272-285. doi: 10.1007/s12016-019-08732-1. PMID: 30903439
Fahey LM, Liacouras CA
Pediatr Clin North Am 2017 Jun;64(3):475-485. doi: 10.1016/j.pcl.2017.01.009. PMID: 28502433
Chan SK, Mahmoudi M
Compr Ther 2009 Fall-Winter;35(3-4):160-6. PMID: 20043612
Moawad FJ, Veerappan GR, Wong RK
Dig Dis Sci 2009 Sep;54(9):1818-28. Epub 2009 Jun 25 doi: 10.1007/s10620-009-0873-6. PMID: 19554448

Prognosis

Fernandez-Becker NQ
Gastroenterol Clin North Am 2021 Dec;50(4):825-841. Epub 2021 Oct 6 doi: 10.1016/j.gtc.2021.08.001. PMID: 34717873
Licari A, Votto M, D'Auria E, Castagnoli R, Caimmi SME, Marseglia GL
Curr Pediatr Rev 2020;16(2):106-114. doi: 10.2174/1573396315666191022154432. PMID: 31642786
Choudhury S, Baker S
Clin Rev Allergy Immunol 2020 Oct;59(2):150-159. doi: 10.1007/s12016-019-08749-6. PMID: 31175521
Sattasathuchana P, Steiner JM
Anim Health Res Rev 2014 Jun;15(1):76-86. Epub 2014 May 12 doi: 10.1017/S1466252314000012. PMID: 24815742
Virchow JC
Dig Dis 2014;32(1-2):54-60. Epub 2014 Feb 28 doi: 10.1159/000357010. PMID: 24603381

Clinical prediction guides

Dellon ES
Dig Dis Sci 2020 Dec;65(12):3434-3447. Epub 2020 Oct 14 doi: 10.1007/s10620-020-06642-3. PMID: 33052498Free PMC Article
Hirano I, Dellon ES, Hamilton JD, Collins MH, Peterson K, Chehade M, Schoepfer AM, Safroneeva E, Rothenberg ME, Falk GW, Assouline-Dayan Y, Zhao Q, Chen Z, Swanson BN, Pirozzi G, Mannent L, Graham NMH, Akinlade B, Stahl N, Yancopoulos GD, Radin A
Gastroenterology 2020 Jan;158(1):111-122.e10. Epub 2019 Oct 5 doi: 10.1053/j.gastro.2019.09.042. PMID: 31593702
Munoz-Persy M, Lucendo AJ
Eur J Pediatr 2018 May;177(5):649-663. Epub 2018 Mar 17 doi: 10.1007/s00431-018-3129-7. PMID: 29549437
Alexander JA
Gastrointest Endosc Clin N Am 2018 Jan;28(1):47-57. Epub 2017 Oct 21 doi: 10.1016/j.giec.2017.07.003. PMID: 29129299
Virchow JC
Dig Dis 2014;32(1-2):54-60. Epub 2014 Feb 28 doi: 10.1159/000357010. PMID: 24603381

Recent systematic reviews

Reddy SB, Ketchem CJ, Dougherty MK, Eluri S, Dellon ES
Neurogastroenterol Motil 2023 Feb;35(2):e14475. Epub 2022 Sep 27 doi: 10.1111/nmo.14475. PMID: 36168184
Mobarki M, Dumollard JM, Dal Col P, Camy F, Peoc'h M, Karpathiou G
Pathol Res Pract 2020 Apr;216(4):152865. Epub 2020 Feb 12 doi: 10.1016/j.prp.2020.152865. PMID: 32089415
Moole H, Jacob K, Duvvuri A, Moole V, Dharmapuri S, Boddireddy R, Uppu A, Puli SR
Medicine (Baltimore) 2017 Apr;96(14):e5877. doi: 10.1097/MD.0000000000005877. PMID: 28383396Free PMC Article
Arias A, González-Cervera J, Tenias JM, Lucendo AJ
Gastroenterology 2014 Jun;146(7):1639-48. Epub 2014 Feb 15 doi: 10.1053/j.gastro.2014.02.006. PMID: 24534634
Bohm ME, Richter JE
Aliment Pharmacol Ther 2011 Apr;33(7):748-57. Epub 2011 Feb 14 doi: 10.1111/j.1365-2036.2011.04593.x. PMID: 21320137

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