Vol. 13. Núm. 7.
Páginas 384-391 (Abril 2020)

Actualización
Esofagitis eosinofílica y esofagitis infecciosas y tóxicas

Eosinophilic oesophagitis and infectious and toxic oesophagitis

F. Macías GarcíaJ.E. Domínguez Muñoz
Doi : https://10.1016/j.med.2020.05.003
Opciones
Resumen

Las esofagitis son un grupo de entidades que tienen en común la lesión e inflamación de la mucosa esofágica. Además del reflujo gastroesofágico, la etiología de estas entidades es múltiple, destacando entre ellas los medicamentos, los agentes infecciosos o su afectación en el contexto de patologías inmunoalérgicas. La disfagia, la odinofagia, el dolor torácico o la impactación alimentaria suelen ser las manifestaciones sintomáticas más frecuentes. En esta actualización trataremos los tipos más frecuentes de esofagitis, exceptuando la enfermedad por reflujo gastroesofágico, desde el diagnóstico clínico hasta el manejo terapéutico posterior.

Palabras clave
Esofagitis
Disfagia
Esofagitis eosinofílica
Esofagitis infecciosa
Esofagitis tóxica
Abstract

Oesophagitis is a group of entities that have in common the injury and inflammation of the oesophageal mucosa. In addition to gastro-oesophageal reflux, there are numerous aetiologies for these entities, including drugs, infectious agents and their involvement in the context of immunoallergic diseases. Dysphagia, odynophagia, chest pain and food impaction are usually the most common symptomatic manifestations. In this update, we cover the most common types of oesophagitis (except gastro-oesophageal reflux disease), from the clinical diagnosis to the subsequent therapeutic management.

Keywords
Oesophagitis
Dysphagia
Eosinophilic oesophagitis
Infectious oesophagitis
Toxic oesophagitis

Identifíquese

¿Aún no es suscriptor de la revista?

Comprar el acceso al artículo

Comprando el artículo el pdf del mismo podrá ser descargado

Teléfono para incidencias

De lunes a viernes de 9h a 18h (GMT+1) excepto los meses de julio y agosto que será de 9 a 15h

Llamadas desde España 932 415 960
Llamadas desde fuera de España +34 932 415 960
Bibliografía
[1]
202005200821593748
202005200821593749
A.J. Lucendo, J. Molina-Infante, A. Arias, U. von Arnim, A.J. Bredenoord, C. Bussmann, et al.
Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults.
United European Gastroenterol J., (2017), 5 pp. 335-358
[2]
2020052008215937410
2020052008215937411
E.S. Dellon, C.A. Liacouras, J. Molina-Infante, G.T. Furuta, J.M. Spergel, N. Zevit, et al.
Updated international consensus diagnostic criteria for eosinophilic esophagitis: Proceedings of the AGREE conference.
Gastroenterology., (2018), 155 pp. 1022-1033
[3]
2020052008215937412
S.E. Attwood, T.C. Smyrk, T.R.J.J. Demeester.
Esophageal eosinophilia with dysphagia. A distinct clinicopathologic syndrome.
Dig Dis Sci., (1993), 38 pp. 109-116
[4]
2020052008215937413
M. Greenhawt, S.S. Aceves, J.M. Spergel, M.E. Rothenberg.
The management of eosinophilic esophagitis.
J Allergy Clin Immunol Pract., (2013), 1 pp. 332-340
[5]
2020052008215937414
N. Gonsalves.
Distinct features in the clinical presentations of eosinophilic esophagitis in children and adults: is this the same disease?.
Dig Dis., (2014), 32 pp. 89-92
[6]
2020052008215937415
A. Straumann.
The natural history and complications of eosinophilic esophagitis.
Thorac Surg Clin., (2011), 21 pp. 575-587
[7]
2020052008215937416
2020052008215937417
E.S. Dellon, I. Hirano.
Epidemiology and natural history of eosinophilic esophagitis.
Gastroenterology., (2018), 154 pp. 319-322
[8]
2020052008215937418
E.S. Dellon, W.B. Gibbs, K.J. Fritchie, T.C. Rubinas, L.A. Wilson, J.T. Woosley, et al.
Clinical, endoscopic, and histologic findings distinguish eosinophilic esophagitis from gastroesophageal reflux disease.
Clin Gastroenterol Hepatol., (2009), 7 pp. 1305-1313
[9]
2020052008215937419
A.M. Schoepfer, E. Safroneeva, C. Bussmann, T. Kuchen, S. Portmann, H.U. Simon, et al.
Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner.
Gastroenterology., (2013), 145 pp. 1230-1236
[10]
2020052008215937420
E.S. Dellon, H.P. Kim, S.L. Sperry, D.A. Rybnicek, J.T. Woosley, N.J. Shaheen.
A phenotypic analysis shows that eosinophilic esophagitis is a progressive fibrostenotic disease.
Gastrointest Endosc., (2014), 79 pp. 577-585
[11]
2020052008215937421
E.S. Dellon.
Diagnostics of eosinophilic esophagitis: clinical, endoscopic, and histologic pitfalls.
Dig Dis., (2014), 32 pp. 48-53
[12]
2020052008215937422
C.C. Cotton, S. Eluri, W.A. Wolf, E.S. Dellon.
Six-food elimination diet and topical steroids are effective for eosinophilic esophagitis: a meta-regression.
Dig Dis Sci., (2017), 62 pp. 2408-2420
[13]
2020052008215937423
A.J. Lucendo, A. Arias, J. Molina-Infante.
Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis.
Clin Gastroenterol Hepatol., (2016), 14 pp. 13-22
[14]
2020052008215937424
E.S. Dellon, C.A. Liacouras.
Advances in clinical management of eosinophilic esophagitis.
Gastroenterology., (2014), 147 pp. 1238-1254
[15]
2020052008215937425
T. Imam, S.K. Gupta.
Topical glucocorticoid vs. diet therapy in eosinophilic esophagitis: the need for better treatment options.
Expert Rev Clin Immunol., (2016), 12 pp. 797-799
[16]
2020052008215937426
M. Dougherty, T.M. Runge, S. Eluri, E.S. Dellon.
Esophageal dilation with either bougie or balloon technique as a treatment for eosinophilic esophagitis: a systematic review and meta-analysis.
Gastrointest Endosc., (2017), 86 pp. 581-591
[17]
2020052008215937427
A. Arias, J. González-Cervera, J.M. Tenias, A.J. Lucendo.
Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis.
Gastroenterology., (2014), 146 pp. 1639-1648
[18]
2020052008215937428
G. Vázquez-Elizondo, S. Ngamruengphong, M. Khrisna, K.R. Devault, N.J. Talley, S.R. Achem.
The outcome of patients with oesophageal eosinophilic infiltration after an eight-week trial of a proton pump inhibitor.
Aliment Pharmacol Ther., (2013), 38 pp. 1312-1319
[19]
2020052008215937429
F.J. Moawad, G.R. Veerappan, J.A. Dias, T.P. Baker, C.L. Maydonovitch, R.K. Wong.
Randomized controlled trial comparing aerosolized swallowed fluticasone to esomeprazole for esophageal eosinophilia.
Am J Gastroenterol., (2013), 108 pp. 366-372
[20]
2020052008215937430
J. Molina-Infante, D.A. Katzka, J.P. Gisbert.
Review article: proton pump inhibitor therapy for suspected eosinophilic oesophagitis.
Aliment Pharmacol Ther., (2013), 37 pp. 1157-1164
[21]
2020052008215937431
2020052008215937432
A.J. Lucendo, A. Arias, J. Molina-Infante.
Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis.
Clin Gastroenterol Hepatol., (2016), 14 pp. 13-22
[22]
2020052008215937433
N.Di Tan, Y.L. Xiao, M.H. Chen.
Steroids therapy for eosinophilic esophagitis: Systematic review and meta-analysis.
J Dig Dis., (2015), 16 pp. 431-442
[23]
2020052008215937434
T. Sawas, S. Dhalla, M. Sayyar, P.J. Pasricha, R. Hernaez.
Systematic review with meta-analysis: pharmacological interventions for eosinophilic oesophagitis.
Aliment Pharmacol Ther., (2015), 41 pp. 797-806
[24]
2020052008215937435
A.R. Murali, A. Gupta, B.M. Attar, V. Ravi, P. Koduru.
Topical steroids in eosinophilic esophagitis: systematic review and meta-analysis of placebo controlled randomized clinical trials.
J Gastroenterol Hepatol., (2015), 31 pp. 1111-1119
[25]
2020052008215937436
M-YA Chuang, M.A. Chinnaratha, D.G. Hancock, R. Woodman, G.R. Wong, C. Cock, et al.
Topical steroid therapy for the treatment of eosinophilic esophagitis (EoE): a systematic review and meta-analysis.
Clin Transl Gastroenterol., (2015), 6 pp. e82
[26]
2020052008215937437
S. Miehlke, P. Hruz, M. Vieth, C. Bussmann, U. von Arnim, M. Bajbouj, et al.
A randomised, double-blind trial comparing budesonide formulations and dosages for short-term treatment of eosinophilic oesophagitis.
[27]
2020052008215937438
A. Straumann, S. Conus, L. Degen, C. Frei, C. Bussmann, C. Beglinger, et al.
Long-term budesonide maintenance treatment is partially effective for patients with eosinophilic esophagitis.
Clin Gastroenterol Hepatol., (2011), 9 pp. 400-409
[28]
2020052008215937439
A. Arias, J. González-Cervera, J.M. Tenias, A.J. Lucendo.
Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis.
Gastroenterology., (2014), 146 pp. 1639-1648
[29]
2020052008215937440
J. Molina-Infante, A. Arias, J. Barrio, J. Rodríguez-Sánchez, M. Sánchez-Cazalilla, A.J. Lucendo.
Four-food group elimination diet for adult eosinophilic esophagitis: A prospective multicenter study.
J Allergy Clin Immunol., (2014), 134 pp. 1093-1099
[30]
2020052008215937441
J. Molina-Infante, I. Modolell, J. Alcedo, R. García-Romero, S. Casabona-Frances, A. Prieto-Garcia, et al.
Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: the 2-4-6 study.
United Eur Gastroenterol J., (2016), Suppl5 pp. A126
[31]
2020052008215937442
A.J. Lucendo.
Meta-analysis-based guidance for dietary management in eosinophilic esophagitis.
Curr Gastroenterol Rep., (2015), 17 pp. 464
[32]
2020052008215937443
A. Arias, J. González-Cervera, J.M. Tenias, A.J. Lucendo.
Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis.
Gastroenterology., (2014), 146 pp. 1639-1648
[33]
2020052008215937444
P. Netzer, J.M. Gschossmann, A. Straumann, A. Sendensky, R. Weimann, A.M. Schoepfer.
Corticosteroid-dependent eosinophilic oesophagitis: azathioprine and 6-mercaptopurine can induce and maintain long-term remission.
Eur J Gastroenterol Hepatol., (2007), 19 pp. 865-869
[34]
2020052008215937445
2020052008215937446
K.M. O'Shea, S.S. Aceves, E.S. Dellon, S.K. Gupta, J.M. Spergel, G.T. Furuta, et al.
Pathophysiology of eosinophilic esophagitis.
Gastroenterology., (2018), 154 pp. 333-345
[35]
2020052008215937447
J.B. Wechsler, I. Hirano.
Biological therapies for eosinophilic gastrointestinal diseases.
J Allergy Clin Immunol., (2018), 142 pp. 24-31
[36]
2020052008215937448
F.J. Moawad, J.G. Cheatham, K.J. DeZee.
Meta-analysis: the safety and efficacy of dilation in eosinophilic oesophagitis.
Aliment Pharmacol Ther., (2013), 38 pp. 713-720
[37]
2020052008215937449
A. O’Rourke.
Infective oesophagitis: epidemiology, cause, diagnosis and treatment options.
Curr Opin Otolaryngol Head Neck Surg., (2015), 23 pp. 459-463
[38]
2020052008215937450
M. Bustamante Balén, V. Pertejo Pastor.
Esofagitis infecciosas.
AEG Tratamiento de las enfermedades gastroenterológicas, 3ª ed., Elsevier Doyma, (2011),
[39]
2020052008215937451
G.N. Zografos, D. Georgiadou, D. Thomas, G. Kaltsas, M. Digalakis.
Drug-induced esophagitis.
Dis Esophagus., (2009), 22 pp. 633-637