tailieunhanh - Eosinophilic Esophagitis: an Emerging Clinicopathologic Disease of Children and Adults

Examples of duct dependent circulations include critical coarctation of the aorta (duct dependent systemic circulation) or pulmonary atresia (duct dependent pulmonary circulation). In critical coarctation there is extreme narrowing of the aorta just where the arterial duct joins the aorta, and blood supply to the lower half of the body is only possible if it passes from the pulmonary artery to the descending aorta via the duct. In pulmonary atresia, the only blood supply to the lungs is that which passes from the aorta to the pulmonary artery via the duct. Continued survival of these babies requires infusion of. | Eosinophilic Esophagitis an Emerging Clinicopathologic Disease of Children and Adults Glenn T. Furuta MD and Alex Straumann MD Dr. Furuta is Attending Physician in the Gastroenterology Division at Children s Hospital Boston and Assistant Professor at Harvard Medical School Boston Mass. Dr. Straumann is Associate Professor and Director of the Department of Gastroenterology at the Kantonsspital Olten Switzerland. Address correspondence to Glenn T. Furuta MD 300 Longwood Ave. Hunnewell Ground Floor Boston MA 02115 Tel 617-355-6058 Fax 617-7300495 E-mail . . Abstract Eosinophililc esophagitis is a clinicopathologic disease characterized clinically by dysphagia and food impaction in adults and nonspecific symptoms of gastroesophageal reflux disease in children and histologically by large numbers of eosinophils in the proximal and distal esophageal epithelium. Importantly these symptoms and histologic abnormalities appear to be unresponsive to proton pump inhibition. Recent clinical and basic studies suggest an allergic etiology but the precise allergen remains unknown and is likely unique for each patient. Endoscopic features suggest ongoing inflammation and range from linear furrowing with whitish exudation to long-segment stricture formation to a fragile crepe paper-like mucosa that is easily split open. Treatments include nutritional restrictions medical management with topical steroids and in stenotic circumstances esophageal dilation. The long-term outcome is still not certain. Keywords Eosinophil allergic esophagitis interleukin-5 esophageal stricture dysphagia food impaction Since 1879 when Paul Erhlich originally identified the eosinophil named after Eos the Greek goddess of dawn clinicians and scientist have puzzled over the nature of this enigmatic cell. Little is known about its overall role in bodily function but the recognition of eosinophilic infiltrates in several gastrointestinal diseases has sparked a recent upsurge in .

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