Eosinophile Ösophagitis – Neues zur Pathogenese, Diagnostik und Therapie

Zusammenfassung

Die eosinophile Ösophagitis (EoE) ist eine Krankheitsentität, der man erst im letzten Jahrzehnt eine erhöhte Aufmerksamkeit gewidmet hat und seitdem wird sie mit deutlich erhöhter Frequenz diagnostiziert. Sie stellt eine chronisch immunvermittelte Entzündung des Ösophagus dar. Bei Erwachsenen ist die Dysphagie das Leitsymptom. Die Diagnose wird durch die Ösophago-Gastro-Duodenoskopie mit Entnahme von Stufenbiopsien aus dem Ösophagus gestellt. Die charakteristischen histopathologischen Veränderungen mit eosinophilen Infiltraten der ösophagealen Mukosa sind der diagnostischen Goldstandard. Bislang gibt es weltweit keine zugelassene Therapie für die EoE, auch wenn topische und systemisch wirkende Kortikosteroide eine hohe Wirksamkeit zeigen. Weitere therapeutische Optionen stellt die Eliminationsdiät und in ausgewählten Fällen die endoskopische Dilatation dar.

Abstract

Eosinophilic esophagitis (EoE) is a clinicopathological condition of the esophagus that has become increasingly recognised over the last decade. EoE represents a chronic immune-mediated inflammatory disease of the esophagus. In adults dysphagia is the predominant symptom. Upper gastrointestinal endoscopy is required in order to take biopsies from the esophagus. The diagnose is confirmed histologically by typical eosinophilic infiltration of the esophagus mucosa. Until now there is no approved therapy world-wide although we know that topic and systemic steroids are highly effective in EoE. Elimination diet is another option and in well selected patients endoscopic balloon dilation represents a therapeutic possibility.

Schlüsselwörter

Ösophagus - eosinophile Ösophagitis - GERD

Key words

esophagus - eosinophilic esophagitis - GERD

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