EOSINOPHILIC ESOPHAGITIS: A LITERATURE REVIEW (Atena Editora)

Abstract

A esophagitis eosinofílica (EoE) is a chronic esophageal condition with an immunological and allergic etiology, characterized by symptoms related to esophageal dysfunction and histological findings of inflammation predominantly involving eosinophils. The aim of this study was to analyze recent research on aspects related to EoE. Methodology involved a search of scientific articles indexed in PubMed and EBSCO databases between 2018 and 2023, yielding 161 articles. Inclusion criteria included articles published within the last 5 years, with full-text availability. Paid articles and those published more than 5 years ago were excluded, resulting in the selection of 25 articles. Results and Discussion: EoE is a globally distributed disease with increasing incidence. Its primary immunological mechanism involves Th2 cells. External factors stimulate Th2 cells to produce interleukins (IL) such as IL-4, IL-5, and IL-13, with the contribution of an IgE-mediated pathway and other mediators like eotaxin-3. Symptoms vary with age and can resemble those of GERD. In children up to preschool age, symptoms include food refusal or intolerance and poor weight gain, while school-aged children commonly experience vomiting, epigastric pain, heartburn, and regurgitation. Treatment of EoE aims to mitigate esophageal inflammation to alleviate symptoms, prevent complications such as esophageal remodeling and fibrosis, and improve patient quality of life. Therapeutic approaches include medications like Proton Pump Inhibitors (PPIs), swallowed topical corticosteroids (fluticasone and budesonide), dietary interventions, mechanical dilation, and biologic medications. Dupilumab 300 mg weekly is the first selective systemic immunomodulatory biologic therapy approved for EoE in patients aged 12 and older, showing clinically significant benefits with a favorable safety profile compared to non-selective systemic immunosuppressants. Conclusion: Diagnosis of EoE is based on clinical and pathological evidence, including symptoms of esophageal dysfunction, mucosal changes, eosinophilic infiltration, and inflammation observed during endoscopy and biopsy. Treatment focuses on reducing esophageal inflammation to alleviate symptoms, prevent complications, and improve patient quality of life.