Эозинофильный эзофагит: что мы знаем и что мы можем?

Abstract

Eosinophilic esophagitis is a chronic immune-mediated disease of the esophagus. It is characterized by severe eosinophilic inflammation of the esophageal mucosa and the develop-ment of submucosal fibrosis. Clinically, it is manifested by swallowing disorders. The pathogen-esis is based on genetically determined disorder of immune response and barrier function of the esophageal mucosa. The diagnosis of esophageal eosinophilic infiltration is established by clinical manifestations and morphology, after excluding diseases that cause esophageal eosinophilia. The criterion for diagnosis is intraepithelial eosinophilic infiltration with 15 or more eosinophils per field of view at magnification ×400 (or ≥60 eosinophils per 1 mm2). Secondary tests, such as measuring serum total immunoglobulin E levels, assessing peripheral blood eosinophilia, and skin allergy tests, are of lesser importance. The primary treatment for this condition is proton pump inhibitors. If the effect is insufficient, topical steroids and dietary restrictions may also be prescribed. Treatment effectiveness is evaluated 6–12 weeks after initiation by analyzing symp-toms and performing esophagogastroduodenoscopy with biopsy. Endoscopic dilatation is rec-ommended as a treatment option for patients experiencing severe dysphagia caused by esopha-geal narrowing. Biologic agents may also be considered as a possible treatment option. KEYWORDS: eosinophilic esophagitis, esophageal dysfunction, intraepithelial eosinophilic infiltration, proton pump inhibitors, topical steroids, diet, endoscopic dilatation, biologic agents. FOR CITATION: Belan E.B., Tibir'kova E.V. Eosinophilic esophagitis: current knowledge and management options? Russian Medical Inquiry. 2024;8(3):150–154 (in Russ.). DOI: 10.32364/2587-6821-2024-8-3-5.