adairАллергология и Иммунология в ПедиатрииAllergology and Immunology in Paediatrics2500-11752712-7958Ассоциация детских аллергологов и иммунологов России10.53529/2500-1175-2025-4-52-63adair-231Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИMEDICAL CASESОсобенности эозинофильных гастроинтестинальных заболеваний у детей: сочетанное эозинофильное поражение пищевода и желудка. Клинический случайPeculiarities of eosinophilic gastrointestinal diseases in children: combined eosinophilic lesions of the esophagus and stomach. A clinical casehttps://orcid.org/0000-0001-5068-7136ПановаИ. В.PanovaI. V.

Панова Ирина Витальевна — д. м. н., доцент, профессор кафедры педиатрии и неонатологии Федерального государственного бюджетного образовательного учреждения высшего образования «Ростовский государственный медицинский университет» Минздрава России

344022, Ростов-на-Дону, пер. Нахичеванский, 29

Irina Vitalievna Panova — Dr. Sci., Associate Professor, Professor, Department of Pediatrics and Neonatology, Rostov State Medical University

29 Nakhichevansky lane, Rostov-on-Don, 344022

pan_tol@list.ruhttps://orcid.org/0009-0002-8225-2908ЕлисееваН. Д.EliseevaN. D.

Елисеева Нина Дмитриевна — старший лаборант кафедры педиатрии и неонатологии Федерального государственного бюджетного образовательного учреждения высшего образования «Ростовский государственный медицинский университет» Минздрава России

344022, Ростов-на-Дону, пер. Нахичеванский, 29

Nina Dmitrievna Eliseeva — Senior Laboratory Assistant, Department of Pediatrics and Neonatology, Rostov State Medical University

29 Nakhichevansky lane, Rostov-on-Don, 344022

Ninel.85@list.ruhttps://orcid.org/0000-0002-1310-6889ДомбаянС. Х.DombayanS. Chr.

Домбаян Светлана Христофоровна — к. м. н., доцент, доцент кафедры педиатрии и неонатологии Федерального государственного бюджетного образовательного учреждения высшего образования «Ростовский государственный медицинский университет» Минздрава России

344022, Ростов-на-Дону, пер. Нахичеванский, 29

Svetlana Christoforovna Dombayan — Cand. Sci., Associate Professor, Associate Professor, Pediatrics and Neonatology, Rostov State Medical University

29 Nakhichevansky lane, Rostov-on-Don, 344022

svetmed@yandex.ruhttps://orcid.org/0000-0001-6407-6117ЧурюкинаЭ. В.ChuryukinaE. V.

Чурюкина Элла Витальевна — к. м. н., доцент, главный научный сотрудник научного отдела клиники НИИ акушерства и педиатрии, доцент кафедры патологической физиологии Федерального государственного бюджетного образовательного учреждения высшего образования «Ростовский государственный медицинский университет» Минздрава России, доцент кафедры клинической иммунологии, аллергологии и лабораторной диагностики Федерального государственного бюджетного образовательного учреждения высшего образования «Кубанский государственный медицинский университет» Минздрава России, региональный руководитель АДАИР

344022, Ростов-на-Дону, пер. Нахичеванский, 29

350063, Краснодар, ул. М. Седина, 4

Ella Vitalievna Churyukina — Cand. Sci., Associate Professor, Chief Researcher of the Scientific Department of the Research Institute of Obstetrics and Pediatrics, Associate Professor of the Department of Pathological Physiology, Rostov State Medical University; Associate Professor of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics, Kuban State Medical University

29 Nakhichevansky lane, Rostov-on-Don, 344022

4 M. Sedina str., Krasnodar, 350063

echuryukina@mail.ruФедеральное государственное бюджетное общеобразовательное учреждение высшего образования «Ростовский государственный медицинский университет» Минздрава РоссииRostov State Medical UniversityФедеральное государственное бюджетное общеобразовательное учреждение высшего образования «Ростовский государственный медицинский университет» Минздрава России; Федеральное государственное бюджетное общеобразовательное учреждение высшего образования «Кубанский государственный медицинский университет» Минздрава РоссииRostov State Medical University; Kuban State Medical University202528012026045263Copyright © Панова И.В., Елисеева Н.Д., Домбаян С.Х., Чурюкина Э.В., 20262026Панова И.В., Елисеева Н.Д., Домбаян С.Х., Чурюкина Э.В.Panova I.V., Eliseeva N.D., Dombayan S.C., Churyukina E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://adair.elpub.ru/jour/article/view/231

Введение. Эозинофильные гастроинтестинальные заболевания — это группа хронических иммуноопосредованных заболеваний желудочно-кишечного тракта, характеризующихся гастроинтестинальными симптомами и патологической эозинофильной инфильтрацией определенных отделов желудочно-кишечного тракта при отсутствии вторичных причин эозинофилии. В зависимости от уровня поражения выделяют эозинофильный эзофагит, эозинофильный гастрит, эозинофильный энтерит и эозинофильный колит. Отсутствие специфических симптомов эозинофильных гастроинтестинальных заболеваний усложняют диагностический процесс, ключевым звеном которого является морфологическое исследование биоптатов слизистой оболочки соответствующего отдела желудочно-кишечного тракта с определением эозинофильной инфильтрации. На сегодняшний день эозинофильный эзофагит у детей является четко определенным заболеванием с установленными рекомендациями, что облегчает диагностику и терапию данной патологии, чего нельзя сказать об эозинофильном гастрите, который остается клинической загадкой с доказательствами, основанными на ограниченных отдельных отчетах о случаях.Описание клинического случая. В публикации представлен клинический случай 9-летней девочки с сочетанным эозинофильным поражением пищевода и желудка. Проведенное в амбулаторных условиях эндоскопическое исследование верхних отделов желудочно-кишечного тракта с последующей морфологической оценкой биоптатов слизистой оболочки пищевода позволило диагностировать эозинофильный эзофагит. Биопсия слизистой оболочки желудка и тонкой кишки не проводилась. Отсутствие стабильной положительной динамики на фоне назначенного лечения привело к госпитализации и повторному обследованию, включающему морфологическое исследование слизистой оболочки пищевода, желудка и кишечника. Обследование выявило эозинофильную инфильтрацию не только слизистой оболочки пищевода (>15/1ПЗ*400), но и антрального отдела желудка (до 67 эозинофилов*5ПЗ*400). В результате поставлен диагноз эозинофильного эзофагита в сочетании с эозинофильным гастритом, по поводу которых были назначены диетотерапия, ингибиторы протонной помпы и глюкокортикостероиды, что привело к улучшению состояния ребенка, купированию болевого синдрома и симптомов диспепсии, формированию клинической ремиссии.Заключение. Несмотря на возрастание количества исследований и числа публикаций в целом — по проблеме эозинофильных гастроинтестинальных заболеваний, по-прежнему остаются дискутабельными критерии диагностики и лечение таких больных. Представленный клинический случай продемонстрировал возникающие сложности для практикующего врача в ведении детей с эозинофильными гастроинтестинальными заболеваниями, в частности сочетанного эозинофильного поражения пищевода и желудка, учитывая малосимптомность и атипичность клинических проявлений этой патологии, что диктует необходимость дальнейшего изучения механизмов развития и совершенствования алгоритма диагностики и лечения данных заболеваний.

Introduction. Eosinophilic gastrointestinal diseases are a group of chronic immune-mediated diseases of the gastrointestinal tract characterized by gastrointestinal symptoms and pathological eosinophilic infiltration of certain parts of the gastrointestinal tract in the absence of secondary causes of eosinophilia. Depending on the lesion level, eosinophilic esophagitis, eosinophilic gastritis, eosinophilic enteritis and eosinophilic colitis are distinguished. The absence of specific symptoms of eosinophilic gastrointestinal diseases complicate the diagnostic process, the key element of which is the morphological examination of biopsies of the mucous membrane of the corresponding part of the gastrointestinal tract to determine eosinophilic infiltration. To date, eosinophilic esophagitis in children is a well-defined disease with established recommendations, which facilitates the diagnosis and treatment of this pathology, which cannot be said about eosinophilic gastritis, which remains a clinical mystery with evidence based on limited individual case reports.Presentation of the clinical case. The publication presents a clinical case of a 9-year-old girl with combined eosinophilic lesions of the esophagus and stomach. An endoscopic examination of the upper gastrointestinal tract performed on an outpatient basis, followed by a morphological assessment of biopsies of the esophageal mucosa, made it possible to diagnose eosinophilic esophagitis. A biopsy of the gastric mucosa and small intestine was not performed. The lack of stable positive dynamics against the background of prescribed treatment led to hospitalization and repeated examination, including morphological examination of the mucous membrane of the esophagus, stomach and intestines. The examination revealed eosinophilic infiltration not only of the mucous membrane of the esophagus (>15/1PH*400), but also of the antrum of the stomach (up to 67 eosinophils*5PH*400). As a result, eosinophilic esophagitis was diagnosed in combination with eosinophilic gastritis, for which diet therapy, proton pump inhibitors and glucocorticosteroids were prescribed, which led to an improvement in the child’s condition, relief of pain and symptoms of dyspepsia, and the formation of clinical remission.Conclusion. Despite the increasing number of studies and publications on the problem of eosinophilic gastrointestinal diseases, the criteria for diagnosis and treatment of such patients remain controversial. The presented clinical case demonstrated the difficulties that arise for a practicing physician in managing children with eosinophilic gastrointestinal diseases, in particular combined eosinophilic lesions of the esophagus and stomach, given the low symptoms and atypical clinical manifestations of this pathology, which necessitates further study of the mechanisms of development and improvement of the algorithm for the diagnosis and treatment of these diseases.

эозинофильные гастроинтестинальные болезниэозинофильный эзофагитэозинофильный гастритдетиподросткиeosinophilic gastrointestinal diseaseseosinophilic esophagitiseosinophilic gastritischildrenteenagersReferencesPapadopoulou A., Amil-Dias J., Auth M.K.-H. et al. Joint ESPGHAN/NASPGHAN Guidelines on Childhood Eosinophilic Gastrointestinal Disorders Beyond Eosinophilic Esophagitis. J Pediatr Gastroenterol Nutr. 2024; 78 (1): 122–152. https://doi.org/10.1097/MPG.0000000000003877.Papadopoulou A., Amil-Dias J., Auth M.K.-H. et al. Joint ESPGHAN/NASPGHAN Guidelines on Childhood Eosinophilic Gastrointestinal Disorders Beyond Eosinophilic Esophagitis. J Pediatr Gastroenterol Nutr. 2024; 78 (1): 122–152. https://doi.org/10.1097/MPG.0000000000003877.Redd W.D., Dellon E.S. Eosinophilic Gastrointestinal Diseases Beyond the Esophagus: An Evolving Field and Nomenclature. J Gastroenterol Hepatol. 2022; 18 (9): 522–528.Redd W.D., Dellon E.S. Eosinophilic Gastrointestinal Diseases Beyond the Esophagus: An Evolving Field and Nomenclature. J Gastroenterol Hepatol. 2022; 18 (9): 522–528.Клинические рекомендации «Эозинофильный эзофагит». Министерство Здравоохранения Российской Федерации. 2022. [Электронный ресурс.] URL: https://lyl.su/YJqZ (дата обращения 29.11.2024 г.).Clinical recommendations “Eosinophilic esophagitis”. The Ministry of Health of the Russian Federation. 2022 [Electronic resource.] URL: https://lyl.su/YJqZ (date of application 29.11.2024). (In Russ.)Захарова И.Н., Османов И.М., Пампура А.Н. и соавторы. Эозинофильный эзофагит: все еще трудно и редко диагностируемое состояние. Клинический случай. Педиатрия. Consilium Medicum. 2021; 1: 57–62. https://doi.org/10.26442/26586630.2021.1.200838.Zakharova I.N., Osmanov I.M., Pampura A.N. et al. Eosinophilic esophagitis: still a difficult and rarely diagnosed condition. A clinical case. J Pediatrics. Consilium Medicum. 2021; 1: 57–62. https://doi.org/10.26442/26586630.2021.1.200838 (In Russ.)Coutry E., Papadopoulou A. Eosinophilic diseases of the gastrointestinal tract in childhood. J Ann is Inside. 2018; 73 (4): 18–28. https://doi.org/10.1159/000493668.Coutry E., Papadopoulou A. Eosinophilic diseases of the gastrointestinal tract in childhood. J Ann is Inside. 2018; 73 (4): 18–28. https://doi.org/10.1159/000493668.Dellon E.S., Hirano I. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology. 2018; 154 (2): 319–332. e3. https://doi.org/10.1053/j.gastro.2017.06.067.Dellon E.S., Hirano I. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology. 2018; 154 (2): 319–332. e3. https://doi.org/10.1053/j.gastro.2017.06.067.Han J.V., Lee K., Shin J.I. et al. Global incidence and prevalence of eosinophilic esophagitis, 1976–2022: a systematic review and meta-analysis. Klin Gastroenterol Hepatol. 2023; 21 (13): 3270–3284.e77. https://doi.org/10.1016/j.cgh.2023.06.005.Han J.V., Lee K., Shin J.I. et al. Global incidence and prevalence of eosinophilic esophagitis, 1976–2022: a systematic review and meta-analysis. Klin Gastroenterol Hepatol. 2023; 21 (13): 3270–3284.e77. https://doi.org/10.1016/j.cgh.2023.06.005.Oliva S., McGowan E.C. Associations of Eosinophilic Gastrointestinal Disorders with Other Gastrointestinal and Allergic Diseases. Immunology and Allergy Clinics of North America. 2024; 44 (2): 329–348. https://doi.org/10.1016/j.iac.2024.01.005.Oliva S., McGowan E.C. Associations of Eosinophilic Gastrointestinal Disorders with Other Gastrointestinal and Allergic Diseases. Immunology and Allergy Clinics of North America. 2024; 44 (2): 329–348. https://doi.org/10.1016/j.iac.2024.01.005.Dillon E.S., Muir A.B., Katzka D.A. et al. Clinical Guidelines: Diagnosis and Treatment of eosinophilic esophagitis. American Journal of Gastroenterology. 2025; 120 (1): 31–59. https://doi.org/10.14309/ajg.000000000000003194.Dillon E.S., Muir A.B., Katzka D.A. et al. Clinical Guidelines: Diagnosis and Treatment of eosinophilic esophagitis. American Journal of Gastroenterology. 2025; 120 (1): 31–59. https://doi.org/10.14309/ajg.000000000000003194.Amil-Dias J., Oliva S., Papadopoulou A. et al. Diagnosis and treatment of eosinophilic esophagitis in children: updated information from the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2024; 79 (2): 394–437. https://doi.org/10.1002/jpn3.12188Amil-Dias J., Oliva S., Papadopoulou A. et al. Diagnosis and treatment of eosinophilic esophagitis in children: updated information from the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2024; 79 (2): 394–437. https://doi.org/10.1002/jpn3.12188.Kennedy K.V., Muir A.B., Ruffner M.A. Pathophysiology of Eosinophilic Esophagitis. Immunology and Allergy Clinics of North America. 2024; 44 (2): 119–128. https://doi.org/10.1016/j.iac.2023.12.001.Kennedy K.V., Muir A.B., Ruffner M.A. Pathophysiology of Eosinophilic Esophagitis. Immunology and Allergy Clinics of North America. 2024; 44 (2): 119–128. https://doi.org/10.1016/j.iac.2023.12.001.Agulló-García A., Cubero J.L., Lezaun A. et al. Clinical and anatomopathological features of eosinophilic oesophagitis in children and adults. J Allergologia et Immunopathologia. 2020; 48 (6): 560–567. https://doi.org/10.1016/j.aller.2020.03.009.Agulló-García A., Cubero J.L., Lezaun A. et al. Clinical and anatomopathological features of eosinophilic oesophagitis in children and adults. J Allergologia et Immunopathologia. 2020; 48 (6): 560–567. https://doi.org/10.1016/j.aller.2020.03.009.Aceves S.S., Alexander J.A., Baron T.H. et al. An endoscopic approach to eosinophilic esophagitis: Consensus Conference of the American Society for Gastrointestinal Endoscopy. Gastrointestinal endosc. 2022; 96 (4): 576–592.e1. https://doi.org/10.1016/j.gie.2022.05.013.Aceves S.S., Alexander J.A., Baron T.H. et al. An endoscopic approach to eosinophilic esophagitis: Consensus Conference of the American Society for Gastrointestinal Endoscopy. Gastrointestinal endosc. 2022; 96 (4): 576–592.e1. https://doi.org/10.1016/j.gie.2022.05.013.Bolton S.M., Kagalwalla A.F., Arva N.K. et al. Mast cell infiltration is associated with persistent symptoms and endoscopic abnormalities, despite the resolution of eosinophilia in infantile eosinophilic esophagitis. Am J Gastroenterol. 2020; 115 (2): 224–233. https://doi.org/10.14309/ajg.00000000000000474.Bolton S.M., Kagalwalla A.F., Arva N.K. et al. Mast cell infiltration is associated with persistent symptoms and endoscopic abnormalities, despite the resolution of eosinophilia in infantile eosinophilic esophagitis. Am J Gastroenterol. 2020; 115 (2): 224–233. https://doi.org/10.14309/ajg.00000000000000474.Morgan D.M., Ruiter B., Smith N. et al. Clonally expanded pathogenic effector T2 cells expressing GPR15 are associated with eosinophilic esophagitis. Sci Immunol. 2021; 6 (62): eabi5586. https://doi.org/10.1126/sciimmunol.abi5586.Morgan D.M., Ruiter B., Smith N. et al. Clonally expanded pathogenic effector T2 cells expressing GPR15 are associated with eosinophilic esophagitis. Sci Immunol. 2021; 6 (62): eabi5586. https://doi.org/10.1126/sciimmunol.abi5586.Kagalwalla A.F., Wexler J.B., Amsden K. et al. Effectiveness of the 4-food elimination diet for children with eosinophilic esophagitis. Wedge Gastroenterol Hepatol. 2017; 15 (11): 1698–1707.e7. https://doi.org/10.1016/j.cgh.2017.05.048.Kagalwalla A.F., Wexler J.B., Amsden K. et al. Effectiveness of the 4-food elimination diet for children with eosinophilic esophagitis. Wedge Gastroenterol Hepatol. 2017; 15 (11): 1698–1707.e7. https://doi.org/10.1016/j.cgh.2017.05.048.Lucendo A.J., Arias Á., Molina-Infante J. Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis. J Clin Gastroenterol Hepatol. 2016; 14 (1): 13–22.e1.Lucendo A.J., Arias Á., Molina-Infante J. Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis. J Clin Gastroenterol Hepatol. 2016; 14 (1): 13–22.e1.Dellon E.S., Woosley J.T., Arrington A. et al. The efficacy of budesonide versus fluticasone for the initial treatment of eosinophilic esophagitis in a randomized controlled trial. Gastroenterology. 2019; 157 (1): 65–73.e5. https://doi.org/10.1053/j.gas-tro.2019.03.014.Dellon E.S., Woosley J.T., Arrington A. et al. The efficacy of budesonide versus fluticasone for the initial treatment of eosinophilic esophagitis in a randomized controlled trial. Gastroenterology. 2019; 157 (1): 65–73.e5. https://doi.org/10.1053/j.gas-tro.2019.03.014.Dellon E.S., Rotenberg M.E., Collins M.H. et al. Dupilumab in adults and adolescents with eosinophilic esophagitis. N Engl J Med. 2022; 387 (25): 2317–2330. https://doi.org/10.1056/NEJMoa2205982.Dellon E.S., Rotenberg M.E., Collins M.H. et al. Dupilumab in adults and adolescents with eosinophilic esophagitis. N Engl J Med. 2022; 387 (25): 2317–2330. https://doi.org/10.1056/NEJMoa2205982.Chehade M., Dellon E.S., Spergel J.M. et al. Dupilumab for Eosinophilic Esophagitis in Patients 1 to 11 Y ears of Age. N Engl J Med. 2024; 390 (24): 2239–2251. https://doi.org/10.1056/NEJMoa2312282.Chehade M., Dellon E.S., Spergel J.M. et al. Dupilumab for Eosinophilic Esophagitis in Patients 1 to 11 Y ears of Age. N Engl J Med. 2024; 390 (24): 2239–2251. https://doi.org/10.1056/NEJMoa2312282.Molina-Infante J., Arias A., Alcedo J. et al. Empirical elimination diet for eosinophilic esophagitis in children and adults: a 2-46 study. J Allergy Clin Immunol. 2018; 141 (4): 1365–1372. https://doi.org/10.1016/j.jaci.2017.08.038.Molina-Infante J., Arias A., Alcedo J. et al. Empirical elimination diet for eosinophilic esophagitis in children and adults: a 2-46 study. J Allergy Clin Immunol. 2018; 141 (4): 1365–1372. https://doi.org/10.1016/j.jaci.2017.08.038.Cleaver K.L., Gonsalves N., Dellon E.S. et al. Elimination diet therapy from one product versus six products for the treatment of eosinophilic esophagitis: a multicenter randomized open trial. Lancet Gastroenterol Hepatol. 2023; 8 (5): 408–421. https://doi.org/10.1016/S2468-1253(23)00012-2.Cleaver K.L., Gonsalves N., Dellon E.S. et al. Elimination diet therapy from one product versus six products for the treatment of eosinophilic esophagitis: a multicenter randomized open trial. Lancet Gastroenterol Hepatol. 2023; 8 (5): 408–421. https://doi.org/10.1016/S2468-1253(23)00012-2.Wexler J.B., Schwartz S., Arva N.K. et al. Single-food elimination diet is effective for the treatment of eosinophilic esophagitis in children. Wedge Gastroenterol Hepatol. 2022; 20 (8): 1748–1756.e11. https://doi.org/10.1016/j.cgh.2021.03.049.Wexler J.B., Schwartz S., Arva N.K. et al. Single-food elimination diet is effective for the treatment of eosinophilic esophagitis in children. Wedge Gastroenterol Hepatol. 2022; 20 (8): 1748–1756.e11. https://doi.org/10.1016/j.cgh.2021.03.049.Coutry E., Papadopoulou A. Eosinophilic diseases of the gastrointestinal tract in childhood. J Ann is Inside. 2018; 73 (4): 18–28. https://doi.org/10.1159/000493668.Coutry E., Papadopoulou A. Eosinophilic diseases of the gastrointestinal tract in childhood. J Ann is Inside. 2018; 73 (4): 18–28. DOI: 10.1159/000493668.Jensen E.T., Martin C.F., Kappelman M.D., Dellon E.S. Prevalence of eosinophilic gastritis, gastroenteritis, and colitis: estimates from a National Administrative Database. J Pediatr Gastroenterol Nutr. 2016; 62 (1): 36–42. https://doi.org/10.1097/MPG.0000000000000865.Jensen E.T., Martin C.F., Kappelman M.D., Dellon E.S. Prevalence of eosinophilic gastritis, gastroenteritis, and colitis: estimates from a National Administrative Database. J Pediatr Gastroenterol Nutr. 2016; 62 (1): 36–42. https://doi.org/10.1097/MPG.0000000000000865.Yamamoto M., Nagashima S., Yamada Y. et al. Comparison of nonesophageal eosinophilic gastrointestinal disorders with eosinophilic esophagitis: a nationwide survey. J Allergy Clin Immunol Pract. 2021; 9 (9): 3339–3349. e8. https://doi.org/10.1016/j.jaip.2021.06.026.Yamamoto M., Nagashima S., Yamada Y. et al. Comparison of nonesophageal eosinophilic gastrointestinal disorders with eosinophilic esophagitis: a nationwide survey. J Allergy Clin Immunol Pract. 2021; 9 (9): 3339–3349. e8. https://doi.org/10.1016/j.jaip.2021.06.026.Pesek R.D., Reed C.C., Muir A.B. et al. Increasing rates of diagnosis, substantial co-occurrence, and variable treatment patterns of eosinophilic gastritis, gastroenteritis, and colitis based on 10-year data across a multicenter consortium. Am J Gastroenterol. 2019; 114 (6): 984–994. https://doi.org/10.14309/ajg.0000000000000228.Pesek R.D., Reed C.C., Muir A.B. et al. Increasing rates of diagnosis, substantial co-occurrence, and variable treatment patterns of eosinophilic gastritis, gastroenteritis, and colitis based on 10-year data across a multicenter consortium. Am J Gastroenterol. 2019; 114 (6): 984–994. https://doi.org/10.14309/ajg.0000000000000228.Zadeh-Esmaeel M.M., Rezaei-Tavirani M., Ali Ahmadi N., Vafae R. Evaluation of gene expression change in eosinophilic gastroenteritis. J Gastroenterol Hepatol Bed Bench. 2019; 12 (3): 239–245. PMID: 31528308 PMCID: PMC6668767.Zadeh-Esmaeel M.M., Rezaei-Tavirani M., Ali Ahmadi N., Vafae R. Evaluation of gene expression change in eosinophilic gastroenteritis. J Gastroenterol Hepatol Bed Bench. 2019; 12 (3): 239–245. PMID: 31528308 PMCID: PMC6668767.Shoda T., Wen T., Caldwell J.M. et al. Molecular, endoscopic, histologic, and circulating biomarker-based diagnosis of eosinophilic gastritis: multi-site study. J Allergy Clin Immunol. 2020; 145 (1): 255–269. https://doi.org/10.1016/j.jaci.2019.11.007.Shoda T., Wen T., Caldwell J.M. et al. Molecular, endoscopic, histologic, and circulating biomarker-based diagnosis of eosinophilic gastritis: multi-site study. J Allergy Clin Immunol. 2020; 145 (1): 255–269. https://doi.org/10.1016/j.jaci.2019.11.007.Li K., Gechong R., Shuang L. et al. Eosinophilic gastroenteritis: pathogenesis, diagnosis, and treatment. Chin Med J (Engl.). 2023; 136 (8): 899–909. https://doi.org/10.1097/CM9.000000000000002511.Li K., Gechong R., Shuang L. et al. Eosinophilic gastroenteritis: pathogenesis, diagnosis, and treatment. Chin Med J (Engl.). 2023; 136 (8): 899–909. https://doi.org/10.1097/CM9.000000000000002511.Licari A., Votto M., D’Auria E. et al. Eosinophilic Gastrointestinal Diseases in Children: A Practical Review. Curr Pediatr Rev. 2020; 16 (2): 106–114. https://doi.org/10.2174/1573396315666191022154432.Licari A., Votto M., D’Auria E. et al. Eosinophilic Gastrointestinal Diseases in Children: A Practical Review. Curr Pediatr Rev. 2020; 16 (2): 106–114. https://doi.org/10.2174/1573396315666191022154432.Votto M., Lenti M.V, De Silvestri A. et al. Evaluation of diagnostic time in pediatric patients with eosinophilic gastrointestinal disorders according to their clinical features. Ital J Pediatr. 2023; 49 (1): 9. https://doi.org/10.1186/s13052-023-01410-1.Votto M., Lenti M.V., De Silvestri A. et al. Evaluation of diagnostic time in pediatric patients with eosinophilic gastrointestinal disorders according to their clinical features. Ital J Pediatr. 2023; 49 (1): 9. doi: 10.1186/s13052-023-01410-1.Pesek R.D., Reed C.C., Collins M.H. et al. Association between endoscopic and histologic findings in a multicenter retrospective cohort of patients with non-esophageal eosinophilic gastrointestinal disorders. J Dig Dis Sci. 2020; 65: 2024–2035. https://doi.org/10.1007/s10620-019-05961-4.Pesek R.D., Reed C.C., Collins M.H. et al. Association between endoscopic and histologic findings in a multicenter retrospective cohort of patients with non-esophageal eosinophilic gastrointestinal disorders. J Dig Dis Sci. 2020; 65: 2024–2035. https://doi.org/10.1007/s10620-019-05961-4.Kennedy K., Muir A.B., Grossman A., et al. Modified oral entericcoated budesonide regimens to treat pediatric eosinophilic gastroenteritis, a single center experience. J Allergy Clin Immunol Pract. 2019; 7 (6): 2059–2061. https://doi.org/10.1016/j.jaip.2019.01.053.Kennedy K., Muir A.B., Grossman A., et al. Modified oral entericcoated budesonide regimens to treat pediatric eosinophilic gastroenteritis, a single center experience. J Allergy Clin Immunol Pract. 2019; 7 (6): 2059–2061. https://doi.org/10.1016/j.jaip.2019.01.053.Guo H., Ji X., Yang G., Jin Y. Abnormal thymic stromal lymphopoietin expression in the gastrointestinal mucosa of patients with eosinophilic gastroenteritis. J Pediatr (Rio J). 2020; 96 (3): 350–355. https://doi.org/10.1016/j.jped.2018.11.012.Guo H., Ji X., Yang G., Jin Y. Abnormal thymic stromal lymphopoietin expression in the gastrointestinal mucosa of patients with eosinophilic gastroenteritis. J Pediatr (Rio J). 2020; 96 (3): 350–355. https://doi.org/10.1016/j.jped.2018.11.012.Корниенко Е.А., Моисеенкова Ю.А., Волкова Н.Л. и др. Эозинофильные поражения желудка и кишечника: клиника, диагностика, лечение. Альманах клинической медицины. 2018; 46 (5): 482–496. https://doi.org/10.18786/2072-0505-2018-46-5-482-496.Kornienko E.A., Moiseyenkova Yu.A., Volkova N.L., et al. Eosinophilic lesions of the stomach and intestines: clinical features, diagnostics, treatment. Almanac of Clinical Medicine. 2018; 46 (5): 482–496. https://doi.org/10.18786/2072-0505-2018-46-5-482-496. (In Russ.)Caldwell J.M., Collins M.H., Stucke E.M., et al. Histologic eosinophilic gastritis is a systemic disorder associated with blood and extragastric eosinophilia, TH2 immunity, and a unique gastric transcriptome. J Allergy Clin Immunol. 2014 Nov; 134 (5): 1114–1124. https://doi.org/10.1016/j.jaci.2014.07.026. Epub 2014 Sep 15. PMID: 25234644; PMC4254306.Caldwell J.M., Collins M.H., Stucke E.M., et al. Histologic eosinophilic gastritis is a systemic disorder associated with blood and extragastric eosinophilia, TH2 immunity, and a unique gastric transcriptome. J Allergy Clin Immunol. 2014 Nov; 134 (5): 1114–1124. https://doi.org/10.1016/j.jaci.2014.07.026. Epub 2014 Sep 15. PMID: 25234644; PMC4254306.Koutria E., Paterelib A., Nonia M., et al. Distribution of eosinophilis in the gastrointestinal tract of children with no organic disease. Annals of Gastroenterology. 2020; 33: 508–515.Koutria E., Paterelib A., Nonia M., et al. Distribution of eosinophilis in the gastrointestinal tract of children with no organic disease. Annals of Gastroenterology. 2020; 33: 508–515.

The authors declare that there are no conflicts of interest present.