What are Eosinophilic Disorders?

Eosinophilic esophagitis (EoE) is the most common type of eosinophilic gastrointestinal disorder (EGID). EGIDs are a group of diseases where a large number of eosinophils abnormally infiltrate the lining of different parts of the gastrointestinal tract, causing inflammation.

EoE is a chronic EGID that happens in the esophagus – the tube that connects the back of your throat to your stomach. When you swallow, food and liquid travel down the tube. In EoE, a person’s immune system reacts to allergens in the esophagus, producing and multiplying eosinophils in the esophageal lining and causing inflammation. As a result, the esophagus may narrow and develop rings or pus-filled infections (abscesses). These changes can cause difficulty swallowing and other symptoms.

Affecting around 1 in 1,500 children, eosinophilic gastrointestinal disorders (EGIDs) are a group of diseases where large number of eosinophils abnormally infiltrate the lining of the gastrointestinal tract, causing inflammation. Other EGIDs beside eosinophilic esophagitis (EoE) include:

• Eosinophilic gastritis (EG): targets the stomach
• Eosinophilic duodenitis (ED): targets the small intestine
• Eosinophilic Colitis (EC): targets the large intestine

These conditions can produce a number of gastrointestinal symptoms, including:

• Vomiting
• Difficulty swallowing
• Pain during swallowing
• Abdominal pain
• Diarrhea
• Poor weight gain

The pediatric allergists and immunologists at UH Rainbow Babies & Children’s offer coordinated diagnosis, treatment, intervention, nutritional assessment and education for EoE, EG, ED and EC, supported by multidisciplinary care with pediatric gastroenterologists, dietitians and other specialists. Among the procedures arranged through our clinic are:

• Endoscopy and colonoscopy with biopsy
• Interventional esophageal dilation
• pH impedance studies
• Esophageal motility testing
• Allergy testing

Hypereosinophilic Syndromes (HES) are a group of rare disorders where elevated numbers of eosinophils are found in the blood and tissue, all known causes of eosinophilia are ruled out, and eosinophils are causing damage to body organs. While most people have blood eosinophil levels of less than 500/milliliter, people with HES usually have blood levels in excess of 1,500/milliliter.

HES can eventually cause tissue damage in multiple organs as abnormally high levels of eosinophils infiltrate different tissues and cause inflammation. HES can affect any organ in the body, including the stomach and intestines, heart, lungs and skin.

At UH Rainbow Babies & Children’s, our pediatric allergists and immunologists offer the latest in laboratory and imaging tests to diagnose suspected cases of HES in children and adults. We also offer innovative treatment options to reduce high eosinophil counts and prevent tissue damage, especially to the heart and other vital organs.

Your available treatment options include steroids and targeted immune therapies and depend on the type of HES you have.