Eosinophilic Gastroenteritis

An Update

Alfredo J Lucendo; Angel Arias

Disclosures

Expert Rev Gastroenterol Hepatol. 2012;6(5):591-601. 

In This Article

Five-year View

Over the next 5 years, investigators should focus on clarifying several important aspects of EGE that still remain unclear. First of all, clinical presentation, allergic diatheses association, and response to therapies (especially dietary therapies) vary widely from case to case. We should keep in mind that an eosinophil-rich infiltration of the gastrointestinal wall structures and its derived symptoms may represent the ultimate common phenotype resulting from the convergence of different activation forms of inflammation, which cannot be identical in each case.[26] Molecular analysis of heterogeneous patients will thus shed light on whether EGE should be considered as a unique disease or several disorders sharing common features.

Similarly, the natural history of the disease should be clearly defined. We do not know whether the disease in children and adults is equivalent, nor whether the pediatric forms tend to last into adulthood. There is also a shortage of data concerning the ability of different therapeutic modalities to change the natural history of the disease. Scant, but important, studies have defined different behavioral patterns in EGE patients treated with corticosteroids, but data on dietary interventions and their sustained effects are lacking. Moreover, neither the long-term outcome of patients requiring surgery after obstruction or perforation, nor the increase in reports of labor-associated EGE have been reported.

Only long-term follow-up reports can clarify this point, with the available case series reports being further analyzed after several years in order to define the real outcome and significance of EGE. Results from the recently established online database case registry are also awaited in order to gain insight into the current unknowns of this disease.

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