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Martin Storr - One of the best experts on this subject based on the ideXlab platform.

  • Eosinophilic Colitis is a sporadic self limited disease of middle aged people a population based study
    Colorectal Disease, 2014
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer, Stefan J Urbanski
    Abstract:

    Aim Eosinophilic Colitis (EC) is a rare manifestation of Eosinophilic gastrointestinal disorders. Due to its rarity, little information is available on its natural history. Method From the single population-based pathology database of the Calgary Health Region (comprising a population of 1.28 million in 2008), cases of EC during the period 1996–2008 were identified. Medical records of all adults diagnosed with EC were identified and the pathology reviewed. The patients were then contacted for follow-up using a standardized questionnaire. Results Seven cases of EC (four in women) were identified, with a median follow-up of 45 (23–79) months. The median age at diagnosis was 42 (22–70) years. Symptoms at diagnosis were abdominal pain (86%), nonbloody diarrhoea (57%), bloody diarrhoea (29%) and significant (>10%) weight loss (29%). Three patients gave a history of allergic reactions to drugs and four reported allergy to cows' milk. Endoscopic findings were nonspecific, ranging from oedema to small aphthous ulceration. An Eosinophilic infiltrate was identified in the lamina propria in the initial colonic biopsy in all patients. Over the longer term, three patients experienced spontaneous resolution without treatment. Two continued to have mild diarrhoea and abdominal cramps but did not require medical therapy. Two patients required medical treatment by 5-aminosalicylic acid, with one requiring prednisone and azathioprine maintenance therapy. Conclusion Eosinophilic Colitis is a rare mostly self-limiting disease affecting middle-aged adults. It usually has a mild clinical course and drug treatment is not usually necessary. When required, drug treatment follows the standard medication for other inflammatory bowel disease.

  • Eosinophilic Colitis an update on pathophysiology and treatment
    British Medical Bulletin, 2011
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disorders, a spectrum of inflammatory conditions, occurs when eosinophils selectively infiltrate the gut in the absence of known causes for such tissue eosinophilia. These may be classified into Eosinophilic esophagitis, Eosinophilic gastroenteritis and Eosinophilic Colitis (EC). This review focuses on EC: its pathogenesis, epidemiology, clinical presentation, diagnosis and current approach to treatment. Sources of data: A literature review published in English was performed using Pubmed, Ovid, Google scholar search engines with the following keywords: Eosinophilic gastrointestinal disorder, EC, eosinophils, Colitis and gastrointestinal. Areas of agreement: The basis for primary EC appears related to increased sensitivity to allergens, principally as a food allergy in infants and a T lymphocyte-mediated event in adults. Endoscopic changes are generally modest, featuring edema and patchy granularity. Areas of controversy: Clear clinical and pathological diagnostic criteria of EC and its management strategy. Growing points: Intestinal involvement of EC is primarily mucosal, presenting as a mild self-limited proctitis in infants and self-limited Colitis in young adults. Therapeutic approaches based on case reports tend to use either elimination diets to avoid a presumed allergen; agents traditionally used in inflammatory disease or targeted drugs like anti-histamines or leukotriene receptor antagonists. Areas timely for developing research: Prospective randomized controlled trials addressing the disease natural history, possible preventive methods and effective medical approach and long-term prognosis are required.

  • Eosinophilic Colitis epidemiology clinical features and current management
    Therapeutic Advances in Gastroenterology, 2011
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer
    Abstract:

    Primary Eosinophilic gastrointestinal disorders (EGIDs) represent a spectrum of inflammatory gastrointestinal disorders in which eosinophils infiltrate the gut in the absence of known causes for such tissue eosinophilia. EGIDs can be subgrouped as Eosinophilic esophagitis (EE), Eosinophilic gastroenteritis (EG), and Eosinophilic Colitis (EC). The least frequent manifestation of EGIDs is EC. EC is a heterogeneous entity with a bimodal age distribution, presenting with either an acute self-limited bloody diarrhea in otherwise healthy infants or as a more chronic relapsing Colitis in young adults. The pathophysiology of primary EC appears related to altered hypersensitivity, principally as a food allergy in infants and T lymphocyte-mediated (i.e. non-IgE associated) in young adults. In adults, symptoms include diarrhea, abdominal pain, and weight loss. Endoscopic changes are generally modest, featuring edema and patchy granularity. Although standardized criteria are not yet established, the diagnosis of EC depends on histopathology that identifies an excess of eosinophils. Therapeutic approaches are based on case reports and small case series, as prospective randomized controlled trials are lacking. Eosinophilic Colitis in infants is a rather benign, frequently food-related entity and dietary elimination of the aggressor often resolves the disorder within days. Adolescent or older patients require more aggressive medical management including: glucocorticoids, anti-histamines, leukotriene receptors antagonists as well as novel approaches employing biologics that target interleukin-5 (IL-5) and IgE. This review article summarizes the current knowledge of EC, its epidemiology, clinical manifestations, diagnosis, and treatment.

  • w1914 clinical features of Eosinophilic Colitis a report of 7 consecutive cases
    Gastroenterology, 2010
    Co-Authors: Abdulrahman A Alfadda, Eldon A Shaffer, Stefan J Urbanski, Martin Storr
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disease (EGID) is a rare spectrum of gastrointestinal disorders that primarily affects the gastrointestinal tract. EGID causes inflammation rich in Eosinophilic cells in the absence of known causes for eosinophilia. Eosinophilic Colitis (EC) represents the least frequent manifestation of EGID and it is unknown whether it represents an independent group of diseases. Methods: The pathology database of the Calgary Health Region was used to identify all cases of EGID and EC. The medical records of all seven patients diagnosed with EC in the Calgary Health Region from 1996-2008 were retrospectively reviewed and the diagnosis was again confirmed by an expert pathologist. Results: The median age of presentation was 42 years. Four patients (57.1%) were females and three (42.9%) were males. Abdominal pain was present in six patients (85.7%), nonbloody diarrhea in four patients (57.1%), bloody diarrhea in two (28.6%) and two patients (28.6%) had more than 10% significant weight loss. Four patients (57.1%) reported a history of drug allergies indicating a predisposition towards allergic diseases but in none of the patients a distinct allergy causing EC was identified. Two patients (28.6%) were on non steroidal anti-inflammatory drugs at diagnosis. One patient (14.3%) was found to have additional peripheral eosinophilia. On histology, all patients had Eosinophilic infiltrate in the Lamina propria, two (28.6%) had additional Muscularis propria infiltrate, and four patients (57.1%) had cryptitis. Conclusion: EC is a rare medical condition with different patterns of presentations. A high index of suspicion is needed to diagnose this disease. Pathology plays a crucial rule in diagnosis and colonic biopsies are important to rule out EC for the indication diarrhea.

  • W1914 Clinical Features of Eosinophilic Colitis – A Report of 7 Consecutive Cases
    Gastroenterology, 2010
    Co-Authors: Abdulrahman A Alfadda, Eldon A Shaffer, Stefan J Urbanski, Martin Storr
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disease (EGID) is a rare spectrum of gastrointestinal disorders that primarily affects the gastrointestinal tract. EGID causes inflammation rich in Eosinophilic cells in the absence of known causes for eosinophilia. Eosinophilic Colitis (EC) represents the least frequent manifestation of EGID and it is unknown whether it represents an independent group of diseases. Methods: The pathology database of the Calgary Health Region was used to identify all cases of EGID and EC. The medical records of all seven patients diagnosed with EC in the Calgary Health Region from 1996-2008 were retrospectively reviewed and the diagnosis was again confirmed by an expert pathologist. Results: The median age of presentation was 42 years. Four patients (57.1%) were females and three (42.9%) were males. Abdominal pain was present in six patients (85.7%), nonbloody diarrhea in four patients (57.1%), bloody diarrhea in two (28.6%) and two patients (28.6%) had more than 10% significant weight loss. Four patients (57.1%) reported a history of drug allergies indicating a predisposition towards allergic diseases but in none of the patients a distinct allergy causing EC was identified. Two patients (28.6%) were on non steroidal anti-inflammatory drugs at diagnosis. One patient (14.3%) was found to have additional peripheral eosinophilia. On histology, all patients had Eosinophilic infiltrate in the Lamina propria, two (28.6%) had additional Muscularis propria infiltrate, and four patients (57.1%) had cryptitis. Conclusion: EC is a rare medical condition with different patterns of presentations. A high index of suspicion is needed to diagnose this disease. Pathology plays a crucial rule in diagnosis and colonic biopsies are important to rule out EC for the indication diarrhea.

Eldon A Shaffer - One of the best experts on this subject based on the ideXlab platform.

  • Eosinophilic Colitis is a sporadic self limited disease of middle aged people a population based study
    Colorectal Disease, 2014
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer, Stefan J Urbanski
    Abstract:

    Aim Eosinophilic Colitis (EC) is a rare manifestation of Eosinophilic gastrointestinal disorders. Due to its rarity, little information is available on its natural history. Method From the single population-based pathology database of the Calgary Health Region (comprising a population of 1.28 million in 2008), cases of EC during the period 1996–2008 were identified. Medical records of all adults diagnosed with EC were identified and the pathology reviewed. The patients were then contacted for follow-up using a standardized questionnaire. Results Seven cases of EC (four in women) were identified, with a median follow-up of 45 (23–79) months. The median age at diagnosis was 42 (22–70) years. Symptoms at diagnosis were abdominal pain (86%), nonbloody diarrhoea (57%), bloody diarrhoea (29%) and significant (>10%) weight loss (29%). Three patients gave a history of allergic reactions to drugs and four reported allergy to cows' milk. Endoscopic findings were nonspecific, ranging from oedema to small aphthous ulceration. An Eosinophilic infiltrate was identified in the lamina propria in the initial colonic biopsy in all patients. Over the longer term, three patients experienced spontaneous resolution without treatment. Two continued to have mild diarrhoea and abdominal cramps but did not require medical therapy. Two patients required medical treatment by 5-aminosalicylic acid, with one requiring prednisone and azathioprine maintenance therapy. Conclusion Eosinophilic Colitis is a rare mostly self-limiting disease affecting middle-aged adults. It usually has a mild clinical course and drug treatment is not usually necessary. When required, drug treatment follows the standard medication for other inflammatory bowel disease.

  • Eosinophilic Colitis an update on pathophysiology and treatment
    British Medical Bulletin, 2011
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disorders, a spectrum of inflammatory conditions, occurs when eosinophils selectively infiltrate the gut in the absence of known causes for such tissue eosinophilia. These may be classified into Eosinophilic esophagitis, Eosinophilic gastroenteritis and Eosinophilic Colitis (EC). This review focuses on EC: its pathogenesis, epidemiology, clinical presentation, diagnosis and current approach to treatment. Sources of data: A literature review published in English was performed using Pubmed, Ovid, Google scholar search engines with the following keywords: Eosinophilic gastrointestinal disorder, EC, eosinophils, Colitis and gastrointestinal. Areas of agreement: The basis for primary EC appears related to increased sensitivity to allergens, principally as a food allergy in infants and a T lymphocyte-mediated event in adults. Endoscopic changes are generally modest, featuring edema and patchy granularity. Areas of controversy: Clear clinical and pathological diagnostic criteria of EC and its management strategy. Growing points: Intestinal involvement of EC is primarily mucosal, presenting as a mild self-limited proctitis in infants and self-limited Colitis in young adults. Therapeutic approaches based on case reports tend to use either elimination diets to avoid a presumed allergen; agents traditionally used in inflammatory disease or targeted drugs like anti-histamines or leukotriene receptor antagonists. Areas timely for developing research: Prospective randomized controlled trials addressing the disease natural history, possible preventive methods and effective medical approach and long-term prognosis are required.

  • Eosinophilic Colitis epidemiology clinical features and current management
    Therapeutic Advances in Gastroenterology, 2011
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer
    Abstract:

    Primary Eosinophilic gastrointestinal disorders (EGIDs) represent a spectrum of inflammatory gastrointestinal disorders in which eosinophils infiltrate the gut in the absence of known causes for such tissue eosinophilia. EGIDs can be subgrouped as Eosinophilic esophagitis (EE), Eosinophilic gastroenteritis (EG), and Eosinophilic Colitis (EC). The least frequent manifestation of EGIDs is EC. EC is a heterogeneous entity with a bimodal age distribution, presenting with either an acute self-limited bloody diarrhea in otherwise healthy infants or as a more chronic relapsing Colitis in young adults. The pathophysiology of primary EC appears related to altered hypersensitivity, principally as a food allergy in infants and T lymphocyte-mediated (i.e. non-IgE associated) in young adults. In adults, symptoms include diarrhea, abdominal pain, and weight loss. Endoscopic changes are generally modest, featuring edema and patchy granularity. Although standardized criteria are not yet established, the diagnosis of EC depends on histopathology that identifies an excess of eosinophils. Therapeutic approaches are based on case reports and small case series, as prospective randomized controlled trials are lacking. Eosinophilic Colitis in infants is a rather benign, frequently food-related entity and dietary elimination of the aggressor often resolves the disorder within days. Adolescent or older patients require more aggressive medical management including: glucocorticoids, anti-histamines, leukotriene receptors antagonists as well as novel approaches employing biologics that target interleukin-5 (IL-5) and IgE. This review article summarizes the current knowledge of EC, its epidemiology, clinical manifestations, diagnosis, and treatment.

  • w1914 clinical features of Eosinophilic Colitis a report of 7 consecutive cases
    Gastroenterology, 2010
    Co-Authors: Abdulrahman A Alfadda, Eldon A Shaffer, Stefan J Urbanski, Martin Storr
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disease (EGID) is a rare spectrum of gastrointestinal disorders that primarily affects the gastrointestinal tract. EGID causes inflammation rich in Eosinophilic cells in the absence of known causes for eosinophilia. Eosinophilic Colitis (EC) represents the least frequent manifestation of EGID and it is unknown whether it represents an independent group of diseases. Methods: The pathology database of the Calgary Health Region was used to identify all cases of EGID and EC. The medical records of all seven patients diagnosed with EC in the Calgary Health Region from 1996-2008 were retrospectively reviewed and the diagnosis was again confirmed by an expert pathologist. Results: The median age of presentation was 42 years. Four patients (57.1%) were females and three (42.9%) were males. Abdominal pain was present in six patients (85.7%), nonbloody diarrhea in four patients (57.1%), bloody diarrhea in two (28.6%) and two patients (28.6%) had more than 10% significant weight loss. Four patients (57.1%) reported a history of drug allergies indicating a predisposition towards allergic diseases but in none of the patients a distinct allergy causing EC was identified. Two patients (28.6%) were on non steroidal anti-inflammatory drugs at diagnosis. One patient (14.3%) was found to have additional peripheral eosinophilia. On histology, all patients had Eosinophilic infiltrate in the Lamina propria, two (28.6%) had additional Muscularis propria infiltrate, and four patients (57.1%) had cryptitis. Conclusion: EC is a rare medical condition with different patterns of presentations. A high index of suspicion is needed to diagnose this disease. Pathology plays a crucial rule in diagnosis and colonic biopsies are important to rule out EC for the indication diarrhea.

  • W1914 Clinical Features of Eosinophilic Colitis – A Report of 7 Consecutive Cases
    Gastroenterology, 2010
    Co-Authors: Abdulrahman A Alfadda, Eldon A Shaffer, Stefan J Urbanski, Martin Storr
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disease (EGID) is a rare spectrum of gastrointestinal disorders that primarily affects the gastrointestinal tract. EGID causes inflammation rich in Eosinophilic cells in the absence of known causes for eosinophilia. Eosinophilic Colitis (EC) represents the least frequent manifestation of EGID and it is unknown whether it represents an independent group of diseases. Methods: The pathology database of the Calgary Health Region was used to identify all cases of EGID and EC. The medical records of all seven patients diagnosed with EC in the Calgary Health Region from 1996-2008 were retrospectively reviewed and the diagnosis was again confirmed by an expert pathologist. Results: The median age of presentation was 42 years. Four patients (57.1%) were females and three (42.9%) were males. Abdominal pain was present in six patients (85.7%), nonbloody diarrhea in four patients (57.1%), bloody diarrhea in two (28.6%) and two patients (28.6%) had more than 10% significant weight loss. Four patients (57.1%) reported a history of drug allergies indicating a predisposition towards allergic diseases but in none of the patients a distinct allergy causing EC was identified. Two patients (28.6%) were on non steroidal anti-inflammatory drugs at diagnosis. One patient (14.3%) was found to have additional peripheral eosinophilia. On histology, all patients had Eosinophilic infiltrate in the Lamina propria, two (28.6%) had additional Muscularis propria infiltrate, and four patients (57.1%) had cryptitis. Conclusion: EC is a rare medical condition with different patterns of presentations. A high index of suspicion is needed to diagnose this disease. Pathology plays a crucial rule in diagnosis and colonic biopsies are important to rule out EC for the indication diarrhea.

Abdulrahman A Alfadda - One of the best experts on this subject based on the ideXlab platform.

  • Eosinophilic Colitis is a sporadic self limited disease of middle aged people a population based study
    Colorectal Disease, 2014
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer, Stefan J Urbanski
    Abstract:

    Aim Eosinophilic Colitis (EC) is a rare manifestation of Eosinophilic gastrointestinal disorders. Due to its rarity, little information is available on its natural history. Method From the single population-based pathology database of the Calgary Health Region (comprising a population of 1.28 million in 2008), cases of EC during the period 1996–2008 were identified. Medical records of all adults diagnosed with EC were identified and the pathology reviewed. The patients were then contacted for follow-up using a standardized questionnaire. Results Seven cases of EC (four in women) were identified, with a median follow-up of 45 (23–79) months. The median age at diagnosis was 42 (22–70) years. Symptoms at diagnosis were abdominal pain (86%), nonbloody diarrhoea (57%), bloody diarrhoea (29%) and significant (>10%) weight loss (29%). Three patients gave a history of allergic reactions to drugs and four reported allergy to cows' milk. Endoscopic findings were nonspecific, ranging from oedema to small aphthous ulceration. An Eosinophilic infiltrate was identified in the lamina propria in the initial colonic biopsy in all patients. Over the longer term, three patients experienced spontaneous resolution without treatment. Two continued to have mild diarrhoea and abdominal cramps but did not require medical therapy. Two patients required medical treatment by 5-aminosalicylic acid, with one requiring prednisone and azathioprine maintenance therapy. Conclusion Eosinophilic Colitis is a rare mostly self-limiting disease affecting middle-aged adults. It usually has a mild clinical course and drug treatment is not usually necessary. When required, drug treatment follows the standard medication for other inflammatory bowel disease.

  • Eosinophilic Colitis an update on pathophysiology and treatment
    British Medical Bulletin, 2011
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disorders, a spectrum of inflammatory conditions, occurs when eosinophils selectively infiltrate the gut in the absence of known causes for such tissue eosinophilia. These may be classified into Eosinophilic esophagitis, Eosinophilic gastroenteritis and Eosinophilic Colitis (EC). This review focuses on EC: its pathogenesis, epidemiology, clinical presentation, diagnosis and current approach to treatment. Sources of data: A literature review published in English was performed using Pubmed, Ovid, Google scholar search engines with the following keywords: Eosinophilic gastrointestinal disorder, EC, eosinophils, Colitis and gastrointestinal. Areas of agreement: The basis for primary EC appears related to increased sensitivity to allergens, principally as a food allergy in infants and a T lymphocyte-mediated event in adults. Endoscopic changes are generally modest, featuring edema and patchy granularity. Areas of controversy: Clear clinical and pathological diagnostic criteria of EC and its management strategy. Growing points: Intestinal involvement of EC is primarily mucosal, presenting as a mild self-limited proctitis in infants and self-limited Colitis in young adults. Therapeutic approaches based on case reports tend to use either elimination diets to avoid a presumed allergen; agents traditionally used in inflammatory disease or targeted drugs like anti-histamines or leukotriene receptor antagonists. Areas timely for developing research: Prospective randomized controlled trials addressing the disease natural history, possible preventive methods and effective medical approach and long-term prognosis are required.

  • Eosinophilic Colitis epidemiology clinical features and current management
    Therapeutic Advances in Gastroenterology, 2011
    Co-Authors: Abdulrahman A Alfadda, Martin Storr, Eldon A Shaffer
    Abstract:

    Primary Eosinophilic gastrointestinal disorders (EGIDs) represent a spectrum of inflammatory gastrointestinal disorders in which eosinophils infiltrate the gut in the absence of known causes for such tissue eosinophilia. EGIDs can be subgrouped as Eosinophilic esophagitis (EE), Eosinophilic gastroenteritis (EG), and Eosinophilic Colitis (EC). The least frequent manifestation of EGIDs is EC. EC is a heterogeneous entity with a bimodal age distribution, presenting with either an acute self-limited bloody diarrhea in otherwise healthy infants or as a more chronic relapsing Colitis in young adults. The pathophysiology of primary EC appears related to altered hypersensitivity, principally as a food allergy in infants and T lymphocyte-mediated (i.e. non-IgE associated) in young adults. In adults, symptoms include diarrhea, abdominal pain, and weight loss. Endoscopic changes are generally modest, featuring edema and patchy granularity. Although standardized criteria are not yet established, the diagnosis of EC depends on histopathology that identifies an excess of eosinophils. Therapeutic approaches are based on case reports and small case series, as prospective randomized controlled trials are lacking. Eosinophilic Colitis in infants is a rather benign, frequently food-related entity and dietary elimination of the aggressor often resolves the disorder within days. Adolescent or older patients require more aggressive medical management including: glucocorticoids, anti-histamines, leukotriene receptors antagonists as well as novel approaches employing biologics that target interleukin-5 (IL-5) and IgE. This review article summarizes the current knowledge of EC, its epidemiology, clinical manifestations, diagnosis, and treatment.

  • w1914 clinical features of Eosinophilic Colitis a report of 7 consecutive cases
    Gastroenterology, 2010
    Co-Authors: Abdulrahman A Alfadda, Eldon A Shaffer, Stefan J Urbanski, Martin Storr
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disease (EGID) is a rare spectrum of gastrointestinal disorders that primarily affects the gastrointestinal tract. EGID causes inflammation rich in Eosinophilic cells in the absence of known causes for eosinophilia. Eosinophilic Colitis (EC) represents the least frequent manifestation of EGID and it is unknown whether it represents an independent group of diseases. Methods: The pathology database of the Calgary Health Region was used to identify all cases of EGID and EC. The medical records of all seven patients diagnosed with EC in the Calgary Health Region from 1996-2008 were retrospectively reviewed and the diagnosis was again confirmed by an expert pathologist. Results: The median age of presentation was 42 years. Four patients (57.1%) were females and three (42.9%) were males. Abdominal pain was present in six patients (85.7%), nonbloody diarrhea in four patients (57.1%), bloody diarrhea in two (28.6%) and two patients (28.6%) had more than 10% significant weight loss. Four patients (57.1%) reported a history of drug allergies indicating a predisposition towards allergic diseases but in none of the patients a distinct allergy causing EC was identified. Two patients (28.6%) were on non steroidal anti-inflammatory drugs at diagnosis. One patient (14.3%) was found to have additional peripheral eosinophilia. On histology, all patients had Eosinophilic infiltrate in the Lamina propria, two (28.6%) had additional Muscularis propria infiltrate, and four patients (57.1%) had cryptitis. Conclusion: EC is a rare medical condition with different patterns of presentations. A high index of suspicion is needed to diagnose this disease. Pathology plays a crucial rule in diagnosis and colonic biopsies are important to rule out EC for the indication diarrhea.

  • W1914 Clinical Features of Eosinophilic Colitis – A Report of 7 Consecutive Cases
    Gastroenterology, 2010
    Co-Authors: Abdulrahman A Alfadda, Eldon A Shaffer, Stefan J Urbanski, Martin Storr
    Abstract:

    Background: Primary Eosinophilic gastrointestinal disease (EGID) is a rare spectrum of gastrointestinal disorders that primarily affects the gastrointestinal tract. EGID causes inflammation rich in Eosinophilic cells in the absence of known causes for eosinophilia. Eosinophilic Colitis (EC) represents the least frequent manifestation of EGID and it is unknown whether it represents an independent group of diseases. Methods: The pathology database of the Calgary Health Region was used to identify all cases of EGID and EC. The medical records of all seven patients diagnosed with EC in the Calgary Health Region from 1996-2008 were retrospectively reviewed and the diagnosis was again confirmed by an expert pathologist. Results: The median age of presentation was 42 years. Four patients (57.1%) were females and three (42.9%) were males. Abdominal pain was present in six patients (85.7%), nonbloody diarrhea in four patients (57.1%), bloody diarrhea in two (28.6%) and two patients (28.6%) had more than 10% significant weight loss. Four patients (57.1%) reported a history of drug allergies indicating a predisposition towards allergic diseases but in none of the patients a distinct allergy causing EC was identified. Two patients (28.6%) were on non steroidal anti-inflammatory drugs at diagnosis. One patient (14.3%) was found to have additional peripheral eosinophilia. On histology, all patients had Eosinophilic infiltrate in the Lamina propria, two (28.6%) had additional Muscularis propria infiltrate, and four patients (57.1%) had cryptitis. Conclusion: EC is a rare medical condition with different patterns of presentations. A high index of suspicion is needed to diagnose this disease. Pathology plays a crucial rule in diagnosis and colonic biopsies are important to rule out EC for the indication diarrhea.

Sitang Gong - One of the best experts on this subject based on the ideXlab platform.

  • effectiveness of dietary allergen exclusion therapy on Eosinophilic Colitis in chinese infants and young children 3 years of age
    Nutrients, 2015
    Co-Authors: Min Yang, Lanlan Geng, Peiyu Chen, Fenghua Wang, Zhaohui Xu, Cuiping Liang, Huiwen Li, Tiefu Fang, Craig A Friesen, Sitang Gong
    Abstract:

    Eosinophilic Colitis is a well recognized clinical entity mainly associated with food allergies. Empiric treatment options include dietary allergen exclusion (extensively hydrolyzed protein formula and elimination diet), anti-allergy medications (antihistamines and leukotriene receptor antagonists) and corticosteroids. We evaluated the effectiveness of dietary antigen exclusion on clinical remission of Eosinophilic Colitis in infants and young children. We retrospectively reviewed charts of all infants and children ≤3 years of age who were diagnosed with Eosinophilic Colitis (defined as mucosal eosinophilia ≥20 hpf−1) from 1 January 2011 to 31 December 2013 at a tertiary children’s hospital in China. Forty-nine children were identified with Eosinophilic Colitis. Elemental formula, simple elimination diet or combination therapy resulted in clinical improvement in 75%, 88.2% and 80% of patients, respectively. In conclusion, Eosinophilic Colitis in infants and children ≤3 years of age responded well to dietary allergen exclusion.

  • Effectiveness of dietary allergen exclusion therapy on Eosinophilic Colitis in Chinese infants and young children ≤ 3 years of age.
    Nutrients, 2015
    Co-Authors: Min Yang, Lanlan Geng, Peiyu Chen, Fenghua Wang, Zhaohui Xu, Cuiping Liang, Huiwen Li, Tiefu Fang, Craig A Friesen, Sitang Gong
    Abstract:

    Eosinophilic Colitis is a well recognized clinical entity mainly associated with food allergies. Empiric treatment options include dietary allergen exclusion (extensively hydrolyzed protein formula and elimination diet), anti-allergy medications (antihistamines and leukotriene receptor antagonists) and corticosteroids. We evaluated the effectiveness of dietary antigen exclusion on clinical remission of Eosinophilic Colitis in infants and young children. We retrospectively reviewed charts of all infants and children ≤3 years of age who were diagnosed with Eosinophilic Colitis (defined as mucosal eosinophilia ≥20 hpf−1) from 1 January 2011 to 31 December 2013 at a tertiary children’s hospital in China. Forty-nine children were identified with Eosinophilic Colitis. Elemental formula, simple elimination diet or combination therapy resulted in clinical improvement in 75%, 88.2% and 80% of patients, respectively. In conclusion, Eosinophilic Colitis in infants and children ≤3 years of age responded well to dietary allergen exclusion.

A W Bates - One of the best experts on this subject based on the ideXlab platform.

  • diagnosing Eosinophilic Colitis histopathological pattern or nosological entity
    Scientifica 2012 Article 682576. (2012), 2012
    Co-Authors: A W Bates
    Abstract:

    Reports of  “Eosinophilic Colitis”—raised colonic mucosal eosinophil density in patients with lower gastrointestinal symptoms—have increased markedly over the last fifteen years, though it remains a rarity. There is no consensus over its diagnosis and management, and uncertainty is compounded by the use of the same term to describe an idiopathic increase in colonic eosinophils and an Eosinophilic inflammatory reaction to known aetiological agents such as parasites or drugs. In patients with histologically proven colonic eosinophilia, it is important to seek out underlying causes and careful clinicopathological correlation is advised. Because of the variability of eosinophil density in the normal colon, it is recommended that histological reports of colonic eosinophilia include a quantitative morphometric assessment of eosinophil density, preferably across several sites. Few reported cases of “Eosinophilic Colitis” meet these criteria. As no correlation has been shown between colonic eosinophil density and symptoms in older children or adults, it is suggested that treatment should be directed towards alleviation of symptoms and response to treatment assessed clinically rather than by histological estimates of intramucosal eosinophils.

  • defining Eosinophilic Colitis in children insights from a retrospective case series
    Journal of Pediatric Gastroenterology and Nutrition, 2009
    Co-Authors: Sam Behjati, Matthias Zilbauer, R Heuschkel, A D Phillips, Camilla Salvestrini, Franco Torrente, A W Bates
    Abstract:

    OBJECTIVES: Although it is a well-described syndrome in infants, Eosinophilic Colitis is a loosely defined and poorly understood diagnosis in older children. The aims of this case series were to characterise colonic eosinophilia in children and to determine whether it represents a distinct clinicopathological condition. METHODS: We retrospectively reviewed symptomatic children older than 12 months with the principal diagnosis of colonic eosinophilia who presented between January 2000 and February 2007 (n = 38) and a further 10 children whose colonic biopsies were reported as histologically normal. The eosinophil density in all available gastrointestinal biopsies (n = 620) of these children was determined using a validated quantitative morphometric method. Patients were subdivided according to mean colonic eosinophil levels into 3 groups (marked, moderate, or minimal colonic eosinophilia). The following patient information was obtained and compared among patient groups: symptoms prompting endoscopy, atopic history, outcome, serum C-reactive protein and total immunoglobulin E (IgE) levels, erythrocyte sedimentation rate, blood eosinophil count, and endoscopic findings. RESULTS: In all 3 patient groups, there was a colonic gradient of decreasing eosinophil density from caecum to rectum. Upper gastrointestinal tract biopsies did not exhibit eosinophilia. Although a significant association (P = 0.03) between abnormal total IgE levels and moderate or severe colonic eosinophilia was found, there was no significant difference (P > 0.05) in other patient characteristics. Furthermore, follow-up data did not show a consistent relation between eosinophil density and progression of symptoms. CONCLUSIONS: We find no association between "Eosinophilic Colitis," defined as a histologically demonstrated marked colonic eosinophilia, and symptoms, history of atopy, inflammatory markers, or clinical outcome.