Abstract
Celiac disease is a chronic, immune-mediated disorder, characterized by small intestinal inflammation and villous atrophy after the ingestion of gluten by genetically susceptible individuals. Several extraintestinal manifestations have been associated to celiac disease. Eosinophilic esophagitis is a primary disorder of the esophagus characterized by upper gastrointestinal symptoms, absence of gastroesophageal reflux disease and more than 15 eosinophils per high-power field in biopsy specimens. Both celiac disease and eosinophilic esophagitis are caused by aberrant, but distinct, immune responses to ingested antigens and can be responsive to restricted food intake. The aim of this review is to assess whether there is an association between these two pathologies. In the majority of the studies examined, including the studies in pediatric population, the prevalence of eosinophilic esophagitis in subjects with celiac disease was about 10-times that of the general population. We suggest searching for eosinophilic esophagitis in all children undergoing endoscopy for suspicious celiac disease.
Highlights
Celiac disease is a chronic, immune-mediated disorder, characterized by malabsorption of nutrients after the ingestion of wheat gluten or related proteins from rye and barley by genetically susceptible individuals expressing the human leukocyte antigen (HLA) class II molecules DQ2 or DQ8 [1]resulting in villus atrophy of the small intestinal mucosa
The eosinophilic esophagitis responded to an elimination diet with normalization of esophageal histology and subsequently recurred with reintroduction of cow’s milk protein
A second report of three associated cases was described in the same year [20] with a reported prevalence of eosinophilic esophagitis in patients with celiac disease of 9%, nine times higher than that expected in the general population (1:100) [21]
Summary
Celiac disease is a chronic, immune-mediated disorder, characterized by malabsorption of nutrients after the ingestion of wheat gluten or related proteins from rye and barley by genetically susceptible individuals expressing the human leukocyte antigen (HLA) class II molecules DQ2 or DQ8 [1]resulting in villus atrophy of the small intestinal mucosa. Eosinophilic esophagitis was first described in 1978 [4]; it became recognized as a distinct clinical entity in 1995 [5] It is a chronic inflammatory primary disorder of the esophagus, presenting with dysphagia and symptoms mimicking those of gastroesophageal reflux disease, including vomiting, regurgitation, nausea and epigastric pain. This disorder is characterized by esophageal mucosal biopsy containing more than 15 eosinophils per high-power field (Figure 1) and absence of gastroesophageal reflux disease, as shown by normal pH monitoring or lack of response to high-dose proton pump inhibitory therapy [6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
