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Eosinophilia & Eosinophilic Gastrointestinal Disorders (EGIDs)

Eosinophilia:

Eosinophilia represents an abnormal elevation in eosinophils (a type of white blood cell) in peripheral blood or tissue.   
Causes of eosinophilia include:

  • Atopy/Allergic Diseases
  • Reactive Secondary to Medication
  • Reactive Secondary to Infection
  • Endocrinologic Abnormality
  • Hematologic Abnormality
  • Immunologic Abnormality
  • Associated Syndromes (EGID, Eosinophilic Pneumonia, Eosinophilic Myalgia, Eosinophilic Cellulitis, Churg Strauss, Sarcoid, Wegener’s etc.)
  • Hypereosinophilic Syndrome

Symptoms of eosinophilia are varied and can involve several different organ systems:

  • Skin
  • Lungs
  • Heart
  • Gastrointestinal
  • Neurologic
  • Rheumatologic

Allergists are experts in eosinophilia and diagnose this condition by history, exam, and tests.

The goals of treatment of eosinophilia are to treat current symptoms and prevent worrisome complications.

By visiting an Allergist, you too can take control of your eosinophilia and improve your quality of life.

Eosinophilic Esophagitis:

Eosinophilic esophagitis (EoE) is an allergic inflammatory disorder characterized by eosinophilic infiltration of the esophagus. 

Common symptoms of EoE include:

  • Heartburn (does not respond to usual medications)
  • Difficulty Swallowing
  • Nausea/Vomiting
  • Food Regurgitation
  • Food Impaction
  • Abdominal Pain
  • Chest Pain

In children with EoE, additional findings may include:

  • Poor Weight Gain
  • Weight Loss

Allergists and Gastroenterologists are considered the experts in EoE.

In suspected cases of EoE, patients are prescribed proton pump inhibitors and subsequently undergo esophageal endoscopy with biopsies. Diagnosis of EoE is made by microscopic examination of the biopsies for eosinophilic infiltration.

Foods are frequently associated as an allergenic trigger of EoE. Environmental allergens may also trigger EoE.

To identify food and environmental allergen triggers, three types of testing can be completed:

  • Allergy Skin Testing
  • Specific IgE Blood Testing
  • Food Patch Testing

Please note that allergy skin and specific IgE tests maybe negative as EoE is considered a mixed immune reaction and likely involves both IgE and non-IgE mediated inflammatory mechanisms.

The goals in the treatment of EoE are relief of symptoms and prevention of complications.

Treatment includes:

  • Dietary Management (Food Avoidance)
  • Avoidance of Environmental Triggers (if applicable)
  • Pharmacologic Treatment (Swallowed Steroid)

By visiting an allergist, you too can take control of your EoE and improve your quality of life.

Other Eosinophilic Gastrointestinal Disorders:

Eosinophil associated gastrointestinal disorders (EGID) are characterized by eosinophilic infiltration in different parts of the digestive system.  Eosinophilic esophagitis (EoE) is the most common type of EGID though eosinophilic infiltration may also occur in the stomach, small intestine, and colon.  There is an association between food allergy and EGIDs, especially with EoE.

Eosinophilic Gastritis:

Eosinophilic gastritis (EG) is characterized by eosinophilic infiltration of the stomach.  EG presents with recurrent nausea, vomiting, and abdominal pain.  EG is diagnosed by endoscopy and biopsy of the esophagus, stomach, and small intestine.  Food allergy may play a role in EG.  Treatment of EG involves avoidance of any food triggers and use of medications.

Eosinophilic Gastroenteritis:

Eosinophilic gastroenteritis (EGE) is characterized by eosinophilic infiltration of both the stomach and the small intestine.  EGE causes recurrent symptoms of nausea, vomiting and abdominal pain.  EGE is diagnosed by endoscopy and biopsy of the esophagus, stomach, and small intestine.  Food allergy may play a role in EGE.  Treatment of EGE involves avoidance of any food triggers and use of medications.

Eosinophilic Colitis:

Eosinophilic colitis (EC) is characterized by eosinophilic infiltration of the colon.  EC causes symptoms of nausea, vomiting, abdominal pain, and bloody diarrhea.  EC is diagnosed by endoscopy and biopsy of the large intestine.  Treatment of EC involves avoidance of any food triggers and use of medications.

Allergists and Gastroenterologists are considered the experts in EGID.  Allergists can complete allergy tests to assess for triggers of EGIDs, which are especially relevant for EoE.

By visiting an Allergist, you too can control your symptoms of EGID and improve your quality of life.

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