Abstract：
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by symptoms of esophageal dysfunction and histologically by predominantly eosinophilic infiltration of the squamous epithelium. European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) published a guideline in 2014; however, the rapid evolution of knowledge about pathophysiology, diagnostic criteria, and therapeutic options have made an update necessary.
METHODS: A consensus group of pediatric gastroenterologists from the ESPGHAN Working Group on Eosinophilic Gastrointestinal Diseases (ESPGHAN EGID WG) reviewed the recent literature and proposed statements and recommendations on 28 relevant questions about EoE. A comprehensive electronic literature search was performed in MEDLINE, EMBASE, and Cochrane databases from 2014 to 2022. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the quality of evidence and formulate recommendations.
RESULTS: A total of 52 statements based on the available evidence and 44 consensus-based recommendations are available. A revision of the diagnostic protocol, options for initial drug treatment, and the new concept of simplified empiric elimination diets are now available. Biologics are becoming a part of the potential armamentarium for refractory EoE, and systemic steroids may be considered as the initial treatment for esophageal strictures before esophageal dilation. The importance and assessment of quality of life and a planned transition to adult medical care are new areas addressed in this guideline.
CONCLUSIONS: Research in recent years has led to a better understanding of childhood EoE. This guideline incorporates the new findings and provides a practical guide for clinicians treating children diagnosed with EoE.
METHODS: A consensus group of pediatric gastroenterologists from the ESPGHAN Working Group on Eosinophilic Gastrointestinal Diseases (ESPGHAN EGID WG) reviewed the recent literature and proposed statements and recommendations on 28 relevant questions about EoE. A comprehensive electronic literature search was performed in MEDLINE, EMBASE, and Cochrane databases from 2014 to 2022. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the quality of evidence and formulate recommendations.
RESULTS: A total of 52 statements based on the available evidence and 44 consensus-based recommendations are available. A revision of the diagnostic protocol, options for initial drug treatment, and the new concept of simplified empiric elimination diets are now available. Biologics are becoming a part of the potential armamentarium for refractory EoE, and systemic steroids may be considered as the initial treatment for esophageal strictures before esophageal dilation. The importance and assessment of quality of life and a planned transition to adult medical care are new areas addressed in this guideline.
CONCLUSIONS: Research in recent years has led to a better understanding of childhood EoE. This guideline incorporates the new findings and provides a practical guide for clinicians treating children diagnosed with EoE.
摘要：
背景：嗜酸性粒细胞性食管炎（EoE）是一种慢性食道炎性疾病，其特征是食管功能障碍的症状，组织学上主要是鳞状上皮的嗜酸性粒细胞浸润。欧洲小儿胃肠病学会，肝病学和营养学（ESPGHAN）于2014年发布了指南；然而，病理生理学知识的快速发展，诊断标准,和治疗方案有必要进行更新。
方法：来自ESPGHAN嗜酸粒细胞性胃肠道疾病工作组（ESPGHANEGIDWG）的一组儿科胃肠病学家回顾了最近的文献，并就EoE的28个相关问题提出了陈述和建议。在MEDLINE进行了全面的电子文献检索，EMBASE,和Cochrane数据库从2014年到2022年。建议评估的分级，开发和评估系统用于评估证据质量并制定建议。
结果：共有52份基于现有证据的声明和44份基于共识的建议。诊断方案的修订，初始药物治疗的选择，现在可以使用简化经验性消除饮食的新概念。生物制品正在成为难处理EoE的潜在武器库的一部分，全身性类固醇可被认为是食管扩张前食管狭窄的初始治疗方法。生活质量的重要性和评估以及计划向成人医疗的过渡是本指南中涉及的新领域。
结论：近年来的研究使人们对儿童EoE有了更好的了解。该指南结合了新发现，并为临床医生治疗诊断为EoE的儿童提供了实用指南。
方法：来自ESPGHAN嗜酸粒细胞性胃肠道疾病工作组（ESPGHANEGIDWG）的一组儿科胃肠病学家回顾了最近的文献，并就EoE的28个相关问题提出了陈述和建议。在MEDLINE进行了全面的电子文献检索，EMBASE,和Cochrane数据库从2014年到2022年。建议评估的分级，开发和评估系统用于评估证据质量并制定建议。
结果：共有52份基于现有证据的声明和44份基于共识的建议。诊断方案的修订，初始药物治疗的选择，现在可以使用简化经验性消除饮食的新概念。生物制品正在成为难处理EoE的潜在武器库的一部分，全身性类固醇可被认为是食管扩张前食管狭窄的初始治疗方法。生活质量的重要性和评估以及计划向成人医疗的过渡是本指南中涉及的新领域。
结论：近年来的研究使人们对儿童EoE有了更好的了解。该指南结合了新发现，并为临床医生治疗诊断为EoE的儿童提供了实用指南。
