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 Vol. 17 No. 4, April 2007
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AAP Grand Rounds 17:42 (2007)
© 2007 American Academy of Pediatrics

GASTROENTEROLOGY

Less Invasive Diagnosis and Better Treatment for Eosinophilic Esophagitis

Sources: (1) Konikoff MR, Noel RJ, Blanchard C, et al. A randomized, double-blind, placebo-controlled trial of fluticasone propionate for pediatric eosinophilic esophagitis. Gastroenterology. 2006;131:1381–1391; doi:10.1053/j.gastro.2006.08.033[Medline] (2) Konikoff MR, Blanchard C, Kirby, C, et al. Potential of blood eosinophils, eosinophil-derived neurotaxin and Eotaxin-3 as biomarkers of eosinophilic esophagitis. Gastroenterology. 2006;131:1328–1336; doi:10.1016/j.cgh.2006.08.013

The first 20% of the full text of this article appears below.

Eosinophilic esophagitis (EE) is an increasingly recognized cause of pediatric gastrointestinal morbidity that is often linked to an allergic etiology. Symptoms include nausea, vomiting, abdominal pain, chest pain, heartburn, regurgitation, dysphagia, food impaction, poor appetite, early satiety, fussiness, and poor weight gain. Currently it is diagnosed only by invasive endoscopy. The present report is a randomized, double-blind, placebo-controlled trial of 3 months of swallowed fluticasone propionate (FP) in pediatric patients with EE at Cincinnati Children’s Hospital Medical Center and Children’s Hospital of San Diego. Thirty-six children with EE were randomized to receive either 880µg of FP twice daily, or placebo, for 3 months. The drug was administered via metered dose inhaler, with instructions that it be swallowed. Study patients were assessed with a pre-study and end-of-study esophago-gastro-duodenoscopy with biopsy. The primary outcome, disease remission, was defined by esophageal eosinophil counts of <1 eosinophil/HPF. Among patients . . . [Full Text of this Article]

Amana N. Nasir, MD1 and Neal S. LeLeiko, MD, PhD, FAAP2
1 Pediatric Gastroenterology, Nutrition and Liver Disease, Brown School of Medicine and Hasbro Children’s Hospital, Providence, RI
2 Pediatric Gastroenterology, Nutrition and Liver Disease, Brown School of Medicine and Hasbro Children’s Hospital, Providence, RI

 





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