Eosinophile Ösophagitis und Gastroenteritis – Kolibri oder Chamäleon?

Die eosinophile Ösophagitis ist die häufigste Manifestationsform eosinophiler Erkrankungen des Gastrointestinaltraktes. Sie gilt heute als die zweithäufigste entzündliche Erkrankung der Speiseröhre und als häufigste Ursache für Dysphagie. Dagegen ist die eosinophile Gastroenteritis eine seltene Erkrankung, die zu unterschiedlichen gastrointestinalen Symptomen führen kann. Es existieren primäre und sekundäre Formen. Diagnostisch wegweisend ist der Nachweis einer erhöhten eosinophilen-prädominanten Inflammation der ösophagealen bzw. gastronintestinalen Mukosa/Submukosa. Bei primären Formen gelten Nahrungsmittelantigene als entscheidende Auslöser. Differenzialdiagnostisch müssen unter anderem infektiöse oder medikamentöse Ursachen ausgeschlossen werden. Therapeutisch können Eliminationsdiäten und/oder topische oder systemische Kortikosteroide eingesetzt werden. Bei gutem Ansprechen auf die Therapie ist die Prognose in der Regel günstig, aber auch schwere und therapierefraktäre Verläufe kommen vor.

Eosinophilic esophagitis is the most common manifestation of gastrointestinal eosinophilic diseases. Today it is considered as the second most common inflammatory disorder of the esophagus and the most common cause for dysphagia. In contrast, eosinophilic gastroenteritis is a rare disorder causing variable gastrointestinal symptoms. Primary and secondary forms exist. A typical diagnostic features is the predominantly eosinophilic inflammation of the esophageal or gastrointestinal mucosa/submucosa. Among others etiologies, infectious causes and drug-related manifestations should be excluded. Therapeutic options include eliminations diets and/or steroids. Patients who respond well to treatment usually have a good prognosis, however severe and refractory disease course may occur.

Key words

Eosinophilic esophagitis - eosinophilic gastroenteritis - corticosteroids - eliminations diets - proton pump inhibitors

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