Subtypes of EoE, and exploring eosinophilic gastrointestinal diseases beyond EoE

August 27, 2018

The month is starting to wind down. Football season is just around the corner and hopefully the afternoons will soon begin to cool. I hope you have your copy of this month’s Annals of Allergy, Asthma and Immunology and that you have already read much of it. However, I want to be sure you have noticed two articles in particular that deal with this month’s emphasis of eosinophilic esophagitis (EoE).

The first is a clinical perspective article from Jay A. Lieberman, MD, FACAAI, in Memphis who discusses possible subtypes of EoE. He describes the basis for phenotypes of EoE from an allergic vs. nonallergic etiology (defined as symptoms associated with exposure to antigen-specific IgE) to the variable role of mast cells and even IgG4 associated with eosinophilic infiltration in these patients. He concludes that EoE is a prime example of how a precision medicine-based approach to diagnosis and ultimately therapy has arrived in allergy-immunology.

Another article you must see is by Maureen Egan, MD, and Glenn Furuta, MD, from Denver who explore eosinophilic gastrointestinal diseases (EGID) beyond EoE. They describe symptomatology, pathological findings and approaches to therapy. Many of these patients present with peripheral eosinophilia. Unless they undergo some sort of endoscopy prior to visiting our office, it falls to us to recognize the possibility of EGID and engage our gastroenterology colleagues to reach a diagnosis in these patients. Specific approaches to management are also discussed.

I hope you have made plans to join us for our Annual Scientific Meeting Nov. 15 -19 in Seattle. Until then, look for more scholarly practical features in upcoming issues of Annals of Allergy, Asthma and Immunology.

Gailen Marshall, Jr., MD PhD, FACAAI