ABSTRACT
Eosinophilic esophagitis (EoE) is a chronic, Th2-type immune-mediated disorder. During the past decade, the increasing prevalence of EoE has been recognized in pediatric and adult populations all over the world. EoE diagnosis can be frequent challenging. Three criteria must be met to diagnose EoE: clinical symptoms of esophageal dysfunction, an esophageal biopsy with a peak eosinophil count of at least 15 eosinophils per high-power microscopy field and exclusion of other possible causes of esophageal eosinophilia. Although eosinophils mediate the EoE pathogenesis, proinflammatory cytokines are also critically involved. In the past years biologic therapeutics have revolutionized treatment of EoE.
Subject(s)
Eosinophilic Esophagitis/diagnosis , Adult , Child , Eosinophilic Esophagitis/immunology , Eosinophilic Esophagitis/pathology , HumansABSTRACT
Eosinophilic esophagitis is a chronic, immune-mediated disorder, isolated to the esophagus. Current theory suggests that the former may be caused by cell-mediated food hypersensitivity or may be a subset of eosinophilic gastrointestinal disease, an autoimmune disorder. During the last decade, the increasing prevalence of EoE has been recognized in pediatric populations. Reports support the efficacy of dietary restriction or corticosteroid therapy. Aditional research is needed to determine etiology, allow earlier clinical recognition and improve treatment. Because no single symptom, endoscopic finding or histopathologic feature is pathognomonic, the diagnosis can frequently be challenging. The current article reviews the possible etiology, clinical presentation, diagnosis, and treatment of this disorder, which has been called not only allergic esophagitis (which may be the most important cause), but also eosinophilic esophagitis, primary eosinophilic esophagitis, and idiopathic eosinophilic esophagitis.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Diet/methods , Endoscopy, Gastrointestinal/methods , Eosinophilic Esophagitis , Proton Pump Inhibitors/therapeutic use , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/epidemiology , Eosinophilic Esophagitis/therapy , Global Health , Humans , PrevalenceABSTRACT
BACKGROUND: The Melkersson-Rosenthal syndrome (MRS) is a very rare clinical entity and its classical form is being characterized by the following triad: facial nerve palsy, swelling of the lips and fissured tongue. However, the monosymptomatic form is more common and the typical manifestation is facial edema and/or enlargement of the lips. CASE REPORT: We report a case of monosymptomatic MRS with a positive biopsy of granulomatous cheilitis. CONCLUSIONS: In the daily practice as a pediatrician, it is not usual to diagnose a patient as having MRS. We consider that this is partly because of misdiagnosis. We therefore believe that this case report will supply additional information, in the scope of recurrent facial paralysis and orofacial edema in both children and adults.
Subject(s)
Melkersson-Rosenthal Syndrome/diagnosis , Adolescent , Anti-Inflammatory Agents/therapeutic use , Edema/etiology , Edema/pathology , Female , Humans , Melkersson-Rosenthal Syndrome/complications , Melkersson-Rosenthal Syndrome/pathology , Melkersson-Rosenthal Syndrome/therapy , Tongue, Fissured/diagnosis , Tongue, Fissured/pathology , Triamcinolone Acetonide/therapeutic useABSTRACT
On a number of 135 cases of chronic enteropathies in patients aged 6 months--15 years, the trypsin, amilasis and lipasis levels in duodenal aspirate were investigated. In a high number, the decrease of pancreatic enzymes activity was noted and the majority of cases were accompanied by a marked dystrophy (grades II or III). Thus, it was not possible to indicate whether the low levels were primary or secondary determined.
Subject(s)
Malabsorption Syndromes/etiology , Pancreas/enzymology , Pancreatic Diseases/complications , Adolescent , Amylases/analysis , Child , Child, Preschool , Chronic Disease , Duodenum , Humans , Infant , Intestinal Secretions/enzymology , Lipase/analysis , Malabsorption Syndromes/enzymology , Pancreatic Diseases/enzymology , Trypsin/analysisABSTRACT
The authors studied a number of 445 children with malabsorption in which a jejunal biopsy was done. Concerning the celiac disease, they emphasized the value of jejunal biopsy in diagnosis and monitoring the treatment.
Subject(s)
Celiac Disease/pathology , Atrophy/pathology , Biopsy , Child , Enteritis/pathology , Humans , Intestinal Mucosa/pathology , Jejunal Diseases/pathology , Jejunum/pathologyABSTRACT
Studying a series of 30 children with chronic gastritis (diagnosed by optic fiber gastroscopy and by mucosal biopsy), authors have founded important changes of the superficial mucosa and gastric glands. The histologic changes could explain the well-known functional alterations in chronic gastritis. They discussed also a possible immuno-pathogenic mechanism for these mucosal ultrastructural changes.
Subject(s)
Gastric Mucosa/ultrastructure , Gastritis/pathology , Adolescent , Biopsy, Needle , Child , Child, Preschool , Chronic Disease , Humans , Microscopy, ElectronSubject(s)
Bacteria/isolation & purification , Bacterial Infections/microbiology , Diarrhea, Infantile/microbiology , Diarrhea/microbiology , Genetic Variation , Rotavirus Infections/microbiology , Rotavirus/isolation & purification , Seasons , Bacteria/pathogenicity , Bacterial Infections/epidemiology , Child, Preschool , Diarrhea/epidemiology , Diarrhea, Infantile/epidemiology , Humans , Incidence , Infant , Infant, Newborn , Romania/epidemiology , Rotavirus/pathogenicity , Rotavirus Infections/epidemiologySubject(s)
Celiac Disease/pathology , Intestinal Mucosa/ultrastructure , Jejunum/ultrastructure , Biopsy , Child, Preschool , Female , Humans , Infant , Male , Microscopy, Electron, ScanningSubject(s)
Diarrhea/etiology , Dysentery, Bacillary/complications , Escherichia coli Infections/complications , Rotavirus Infections/complications , Salmonella Infections/complications , Child, Preschool , Diarrhea/microbiology , Dysentery, Bacillary/microbiology , Enterotoxins/isolation & purification , Escherichia coli , Escherichia coli Infections/microbiology , Feces/microbiology , Humans , Infant , Rotavirus/isolation & purification , Rotavirus Infections/microbiology , Salmonella/isolation & purification , Salmonella Infections/microbiology , Shigella/isolation & purificationSubject(s)
Enterocolitis/pathology , Intestinal Mucosa/ultrastructure , Jejunum/ultrastructure , Biopsy , Humans , Infant , Microscopy, ElectronSubject(s)
Antigen-Antibody Complex/immunology , Immune Complex Diseases/etiology , Antigen-Antibody Complex/analysis , Cardiomyopathy, Hypertrophic/diagnosis , Cardiomyopathy, Hypertrophic/etiology , Child , Child, Preschool , Female , Fibroma/diagnosis , Fibroma/etiology , Hepatitis B/diagnosis , Hepatitis B/etiology , Humans , Immune Complex Diseases/diagnosis , Male , Myocarditis/diagnosis , Myocarditis/etiology , Nephrotic Syndrome/diagnosis , Nephrotic Syndrome/etiology , Orbital Neoplasms/diagnosis , Orbital Neoplasms/etiologySubject(s)
Diarrhea, Infantile/pathology , Intestinal Mucosa/pathology , Jejunum/pathology , Humans , InfantABSTRACT
The authors examined microscopically 161 jejunal biopsies of which 142 presented a pathologic mucosa. The two sexes were equally represented and the prevalent age was between 1 and 2 years. Nearly one third of the cases were acute enteritides and the remaining ones--granulative and atrophic enteritides; none of them was hypertrophic. The causes of these enteropathies are various.