Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non‐responsive to proton pump inhibitors
Objective: To compare endoscopic and histologic features of pediatric patients with eosinophilic esophagitis (EoE) responding to proton pump inhibitor (PPI) to those not responding to PPI. Methods: Endoscopic reports and photographs of patients with symptoms of esophageal dysfunction and ≥15 eosinop...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Portuguese |
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Brazilian Society of Pediatrics
2020-09-01
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| Series: | Jornal de Pediatria (Versão em Português) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2255553619301454 |
| _version_ | 1811249342717100032 |
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| author | Gabriela Guimarães Vieira Luciana Bandeira Mendez Ribeiro Sabine Kruger Truppel Nelson Augusto Rosário Filho Mário César Vieira |
| author_facet | Gabriela Guimarães Vieira Luciana Bandeira Mendez Ribeiro Sabine Kruger Truppel Nelson Augusto Rosário Filho Mário César Vieira |
| author_sort | Gabriela Guimarães Vieira |
| collection | DOAJ |
| description | Objective: To compare endoscopic and histologic features of pediatric patients with eosinophilic esophagitis (EoE) responding to proton pump inhibitor (PPI) to those not responding to PPI. Methods: Endoscopic reports and photographs of patients with symptoms of esophageal dysfunction and ≥15 eosinophils per high-powered field (eos/hpf) in esophageal biopsies prior to PPI trial were reviewed. Patients were classified as responsive to PPI (PPIREoE) or non-responsive to PPI (PPINREoE) according to response totreatment (<15 eos/hpf) at second endoscopy after 8 weeks. Results: Of the 231 patients (72.3% male), 64 (27.7%) were responsive to the proton pump inhibitors. Edema (77.3% vs. 62.5%, p = 0.031) and vertical lines (69.5% vs. 51.6%, p = 0.014) were more frequent in PPINREoE patients. An eosinophil count in the mid‐esophagus ≥ 35 eos/HPF (25.1% vs. 12.5%) was more frequent in these patients (p = 0.001). Those with eosinophil count < 15 eos/HPF in the mid‐esophagus at the first endoscopy were more likely to respond to treatment with proton pump inhibitors compared to patients with 15‐34 eos/HPF (p = 0.004, OR: 3.26, 95% CI: 1.46‐7.24) and to patients with ≥ 35 eos/HPF (p = 0.006, OR: 3.20, 95% CI: 1.39‐7.41). Conclusion: Edema and vertical lines at the endoscopy and a higher eosinophil count in the mid‐esophagus were more frequent in patients who were non‐responsive to proton pump inhibitors. As there were no significant differences in the other findings between the groups, it cannot be affirmed that these characteristics are sufficient to differentiate between PPINREoE and PPIREoE patients. Resumo: Objetivo: Comparar características endoscópicas e histológicas entre pacientes com esofagite eosinofílica responsiva (EoERIBP) e não responsiva (EoENRIBP) ao tratamento com inibidores de bomba de prótons. Métodos: Avaliados laudos e imagens endoscópicas de pacientes com sintomas de disfunção esofágica associados a contagem ≥ 15 eosinófilos por campo de grande aumento (eos/CGA) em biópsia do esôfago. Os pacientes foram classificados em responsivos (EoERIBP) ou não responsivos (EoENRIBP) aos inibidores de bomba de prótons conforme resposta ao tratamento na segunda endoscopia (< 15 eos/CGA) após 8 semanas. Resultados: Dos 231 pacientes (72,3% masculino), 64 (27,7%) foram responsivos aos inibidores de bomba de prótons. Edema (77,3% vs. 62,5%, p = 0,031) e linhas verticais (69,5% vs. 51,6%, p = 0,014) foram mais frequentes nos EoENRIBP. A contagem de eosinófilos em esôfago médio ≥ 35 eos/CGA (25,1% vs. 12,5%) foi mais frequente nesses pacientes (p = 0,001). Os que apresentaram contagem de eosinófilos < 15 eos/CGA no esôfago médio à primeira endoscopia apresentaram maior chance de responder ao tratamento com inibidores de bomba de prótons em comparação aos pacientes com 15‐34 eos/CGA (p = 0,004; OR: 3,26; IC95%: 1,46‐7,24) e aos pacientes com ≥ 35 eos/CGA (p = 0,006; OR: 3,20; IC95%: 1,39‐7,41). Conclusão: Edema e linhas verticais à endoscopia e maior contagem de eosinófilos em esôfago médio foram mais frequentes nos pacientes não responsivos aos inibidores de bomba de prótons. Uma vez que não houve diferenças significativas nos outros achados entre os grupos, não se pode afirmar que essas características sejam suficientes para distinguir pacientes com EoENRIBP dos pacientes com EoERIBP. |
| first_indexed | 2024-04-12T15:44:52Z |
| format | Article |
| id | doaj.art-eff2d20203d245f49d531d0e0d6c1397 |
| institution | Directory Open Access Journal |
| issn | 2255-5536 |
| language | Portuguese |
| last_indexed | 2024-04-12T15:44:52Z |
| publishDate | 2020-09-01 |
| publisher | Brazilian Society of Pediatrics |
| record_format | Article |
| series | Jornal de Pediatria (Versão em Português) |
| spelling | doaj.art-eff2d20203d245f49d531d0e0d6c13972022-12-22T03:26:42ZporBrazilian Society of PediatricsJornal de Pediatria (Versão em Português)2255-55362020-09-01965638643Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non‐responsive to proton pump inhibitorsGabriela Guimarães Vieira0Luciana Bandeira Mendez Ribeiro1Sabine Kruger Truppel2Nelson Augusto Rosário Filho3Mário César Vieira4Pontifícia Universidade Católica do Paraná (PUC‐PR), Escola de Medicina, Curitiba, PR, BrasilHospital Pequeno Príncipe, Centro de Gastroenterologia Pediátrica, Curitiba, PR, BrasilHospital Pequeno Príncipe, Centro de Gastroenterologia Pediátrica, Curitiba, PR, BrasilUniversidade Federal do Paraná (UFPR), Departamento de Pediatria, Curitiba, PR, BrasilPontifícia Universidade Católica do Paraná (PUC‐PR), Escola de Medicina, Curitiba, PR, Brasil; Hospital Pequeno Príncipe, Centro de Gastroenterologia Pediátrica, Curitiba, PR, Brasil; Autor para correspondência.Objective: To compare endoscopic and histologic features of pediatric patients with eosinophilic esophagitis (EoE) responding to proton pump inhibitor (PPI) to those not responding to PPI. Methods: Endoscopic reports and photographs of patients with symptoms of esophageal dysfunction and ≥15 eosinophils per high-powered field (eos/hpf) in esophageal biopsies prior to PPI trial were reviewed. Patients were classified as responsive to PPI (PPIREoE) or non-responsive to PPI (PPINREoE) according to response totreatment (<15 eos/hpf) at second endoscopy after 8 weeks. Results: Of the 231 patients (72.3% male), 64 (27.7%) were responsive to the proton pump inhibitors. Edema (77.3% vs. 62.5%, p = 0.031) and vertical lines (69.5% vs. 51.6%, p = 0.014) were more frequent in PPINREoE patients. An eosinophil count in the mid‐esophagus ≥ 35 eos/HPF (25.1% vs. 12.5%) was more frequent in these patients (p = 0.001). Those with eosinophil count < 15 eos/HPF in the mid‐esophagus at the first endoscopy were more likely to respond to treatment with proton pump inhibitors compared to patients with 15‐34 eos/HPF (p = 0.004, OR: 3.26, 95% CI: 1.46‐7.24) and to patients with ≥ 35 eos/HPF (p = 0.006, OR: 3.20, 95% CI: 1.39‐7.41). Conclusion: Edema and vertical lines at the endoscopy and a higher eosinophil count in the mid‐esophagus were more frequent in patients who were non‐responsive to proton pump inhibitors. As there were no significant differences in the other findings between the groups, it cannot be affirmed that these characteristics are sufficient to differentiate between PPINREoE and PPIREoE patients. Resumo: Objetivo: Comparar características endoscópicas e histológicas entre pacientes com esofagite eosinofílica responsiva (EoERIBP) e não responsiva (EoENRIBP) ao tratamento com inibidores de bomba de prótons. Métodos: Avaliados laudos e imagens endoscópicas de pacientes com sintomas de disfunção esofágica associados a contagem ≥ 15 eosinófilos por campo de grande aumento (eos/CGA) em biópsia do esôfago. Os pacientes foram classificados em responsivos (EoERIBP) ou não responsivos (EoENRIBP) aos inibidores de bomba de prótons conforme resposta ao tratamento na segunda endoscopia (< 15 eos/CGA) após 8 semanas. Resultados: Dos 231 pacientes (72,3% masculino), 64 (27,7%) foram responsivos aos inibidores de bomba de prótons. Edema (77,3% vs. 62,5%, p = 0,031) e linhas verticais (69,5% vs. 51,6%, p = 0,014) foram mais frequentes nos EoENRIBP. A contagem de eosinófilos em esôfago médio ≥ 35 eos/CGA (25,1% vs. 12,5%) foi mais frequente nesses pacientes (p = 0,001). Os que apresentaram contagem de eosinófilos < 15 eos/CGA no esôfago médio à primeira endoscopia apresentaram maior chance de responder ao tratamento com inibidores de bomba de prótons em comparação aos pacientes com 15‐34 eos/CGA (p = 0,004; OR: 3,26; IC95%: 1,46‐7,24) e aos pacientes com ≥ 35 eos/CGA (p = 0,006; OR: 3,20; IC95%: 1,39‐7,41). Conclusão: Edema e linhas verticais à endoscopia e maior contagem de eosinófilos em esôfago médio foram mais frequentes nos pacientes não responsivos aos inibidores de bomba de prótons. Uma vez que não houve diferenças significativas nos outros achados entre os grupos, não se pode afirmar que essas características sejam suficientes para distinguir pacientes com EoENRIBP dos pacientes com EoERIBP.http://www.sciencedirect.com/science/article/pii/S2255553619301454Esofagite eosinofílicaEndoscopiaHistologiaInibidores de bomba de prótons |
| spellingShingle | Gabriela Guimarães Vieira Luciana Bandeira Mendez Ribeiro Sabine Kruger Truppel Nelson Augusto Rosário Filho Mário César Vieira Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non‐responsive to proton pump inhibitors Jornal de Pediatria (Versão em Português) Esofagite eosinofílica Endoscopia Histologia Inibidores de bomba de prótons |
| title | Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non‐responsive to proton pump inhibitors |
| title_full | Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non‐responsive to proton pump inhibitors |
| title_fullStr | Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non‐responsive to proton pump inhibitors |
| title_full_unstemmed | Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non‐responsive to proton pump inhibitors |
| title_short | Endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non‐responsive to proton pump inhibitors |
| title_sort | endoscopic and histological characteristics in patients with eosinophilic esophagitis responsive and non responsive to proton pump inhibitors |
| topic | Esofagite eosinofílica Endoscopia Histologia Inibidores de bomba de prótons |
| url | http://www.sciencedirect.com/science/article/pii/S2255553619301454 |
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