Article record

欧洲嗜酸性粒细胞性食管炎指南：儿童和成人诊断与管理的循证声明和建议。第1部分：诊断、流行病学和自然史。

European Guidelines on Eosinophilic Esophagitis: Evidence-Based Statements and Recommendations for Diagnosis and Management in Children and Adults. Part 1: Diagnosis, Epidemiology and Natural History.

指南共识鼻科IF 11.7Q1

文献信息

PMID	42934940
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Alfredo J Lucendo 查看其他 33 位作者 Javier Molina-Infante；Ángel Arias；Ulrike von Arnim；Henrik Bergquist；Luc Biedermann；Albert J Bredenoord；Marie Carlson；Javier Chahuan；Jorge Amil Dias；Thomas Eiwegger；Sara Feo-Ortega；Sandra L Garcia-Dionisio；Matteo Ghisa；Jesús González-Cervera；Thomas Greuter；Danila Guagnozzi；Carolina Gutiérrez-Junquera；Lucía Gutiérrez-Ramírez；Cord Langner；Helen Larsson；Anne Lund Krarup；Salvatore Oliva；Alexandra Papadopoulou；Francesca Racca；Cecilio Santander；Edoardo Vincenzo Savarino；Christoph Schlag；Alain M Schoepfer；Martin A Storr；Antonio Tejera-Muñoz；Noam Zevit；Stephen E Attwood；Alex Straumann
作者单位	Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain. 查看其他 40 条单位信息 Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain.；Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain.；Department of Gastroenterology, Hospital Universitario de Cáceres, Cáceres, Spain.；Research Unit, Hospital Universitario La Mancha Centro, Alcázar de San Juan, Spain.；University Center for Health Sciences-HM Hospital (CUHMED), HM Hospital Health Research Institute, Camilo José Cela University, Madrid, Spain.；Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg, Germany.；Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.；Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland.；Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, the Netherlands.；Department of Medical Sciences, Gastroenterology Research Group, Uppsala University, Uppsala, Sweden.；Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica De Chile, Santiago, Chile.；Hospital Lusíadas, Porto, Portugal.；Department of Pediatrics and Adolescent Medicine, Karl Landsteiner University, Krems, Austria.；Department of Pediatric and Adolescent Medicine, University Hospital St. Poelten, St. Poelten, Austria.；Translational Medicine Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.；Department of Immunology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.；Pediatric Gastroenterology Unit, Hospital General de Tomelloso, Tomelloso, Spain.；Gastrointestinal Endoscopy Unit, Gastroenterology Department, Padova University Hospital, Padua, Italy.；Department of Allergy, Hospital Universitario de Toledo, Toledo, Spain.；Division of Gastroenterology and Hepatology, EOC Lugano, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.；Gastroenterology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.；Laboratory of Neuro-Immuno-Gastroenterology, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.；Pediatric Gastroenterology Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.；Universidad Autónoma de Madrid, Madrid, Spain.；Diagnostic & Research Institute of Pathology, Medical University of Graz, Graz, Austria.；Department of Otorhinolaryngology, Head and Neck Surgery, NU-Hospital Group, Trollhättan, Sweden.；Department of Emergency Medicine, Aalborg University Hospital, Aalborg University, Aalborg, Denmark.；Department of Gastroenterology, Aalborg University Hospital, Aalborg University, Aalborg, Denmark.；Pediatric Gastroenterology and Liver Unit, Sapienza, University of Rome, Rome, Italy.；Keele University, Athens, Greece.；Gastroenterology Department, Children's Hospital Agia Sofia, Athens, Greece.；General Medicine, Humanitas Gavazzeni, Bergamo, Italy.；Department of Gastroenterology and Hepatology, Hospital Universitario de La Princesa, Madrid, Spain.；Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.；Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.；Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.；Center of Endoscopy, MVZ Gauting, Starnberg, Germany.；Institute of Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.；Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.；Department of Health Services Research, Durham University, Durham, UK.
期刊	Allergy
SCI 分区	Q1
IF	11.7
研究类型	指南共识 · 临床
所属专科	鼻科

中文摘要

引言： 嗜酸性粒细胞性食管炎（EoE）已从一种罕见疾病演变为吞咽困难和食物嵌塞的主要原因。本文件（第1部分）为儿童和成人EoE的定义、流行病学、自然史和诊断提供了更新的循证框架，是对2017年欧洲循证指南的更新。
方法： 来自EUREOS、EAACI、ESPGHAN和ESP的32名专家组成的小组制定了这些指南。使用PICO框架在PubMed、Scopus、Embase和Google Scholar中进行了全面的文献检索。应用GRADE方法评估证据的确定性和推荐的强度，同时通过德尔菲法建立共识，要求最低同意阈值为80%。
结果： 这些指南将EoE描述为一种由2型炎症驱动的异质性疾病，其自然史受多种表型和进展风险的影响。EoE的负担急剧上升，年发病率超过10/100,000，合并患病率超过60/100,000，在某些地区超过160/100,000。诊断需要同时具备食管功能障碍症状和食管黏膜中≥15个嗜酸性粒细胞/高倍视野，并排除其他原因。EoE与无症状性食管嗜酸性粒细胞增多症有明确区别。关键诊断建议包括从至少两个食管水平获取至少六份活检，因为仅凭内镜表现缺乏足够的敏感性。除非在任何时候由特定症状或内镜异常驱动，否则不再强制进行胃或十二指肠活检。
结论： 这些指南提供了一个稳健的临床框架，反映了EoE全球患病率的不断增加，并统一了所有年龄组的诊断标准，以改善患者管理。

英文摘要

INTRODUCTION: Eosinophilic esophagitis (EoE) has evolved from a rare condition to the leading cause of dysphagia and food impaction. This document (Part 1) provides an updated evidence-based framework for the definition, epidemiology, natural history, and diagnosis of EoE in children and adults, updating the 2017 European evidence-based guidelines.
METHODS: A panel of 32 experts from EUREOS, EAACI, ESPGHAN, and ESP developed these guidelines. Comprehensive literature searches were conducted (PubMed, Scopus, Embase, and Google Scholar) using the PICO framework. The GRADE methodology was applied to assess the certainty of evidence and strength of recommendations, while consensus was established via the Delphi method, requiring a minimum agreement threshold of 80%.
RESULTS: These guidelines characterize EoE as a heterogeneous condition driven by type 2 inflammation, with natural history influenced by diverse phenotypes and progression risks. EoE burden has risen sharply, with an annual incidence exceeding 10/100,000 and a pooled prevalence over 60/100,000, surpassing 160/100,000 in some regions. Diagnosis requires both symptoms of esophageal dysfunction and ≥ 15 eosinophils/hpf in esophageal mucosa, following the exclusion of alternative causes. EoE is clearly distinguished from asymptomatic esophageal eosinophilia. Key diagnostic recommendations include obtaining at least six biopsies from at least two esophageal levels, as endoscopic appearance alone lacks sufficient sensitivity. Gastric or duodenal biopsies are no longer mandatory unless driven by specific symptoms or endoscopic abnormalities at any point.
CONCLUSIONS: These guidelines provide a robust clinical framework that reflects the increasing global prevalence of EoE and standardizes diagnostic criteria across all age groups to improve patient management.