Transcript Eosinophilic Esophagitis – Erin Copenhaver

Eosinophilic
Esophagitis
Presented by:
Erin
Copenhaver,
PA-C, CHC
Accreditation Information:
The Lowcountry Regional Allergy Update
January 21, 2017
Roper St. Francis Healthcare CME Disclosure Policy:
As a continuing medical education provider, accredited by the South Carolina Medical Association, it is the policy of RSFH
to require all individuals in a position to influence educational content and development of a continuing medical education
activity to disclose all relationships with commercial interests. This information is disclosed to all activity participants.
The following relationships have been disclosed:
Dr. Ned Rupp, Dr. Patricia Gerber, Dr. John Ramey and Erin Copenhaver have received Grant/Research Support from:
Alcon Pharmaceuticals, Amphaster, Apotex, Astellas, AstraZeneca, Boehringer Ingleheim, Genentech, GlaxoSmithKline,
Magna Pharmaceutical, MAP Pharmaceuticals, MedImmune, Merck, Novartis, Sanofi-Aventis, Sepracor (Sunovain), Teva
Pharmaceuticals, Vecture, Inflamax, Aimmune, Regeneron, Baxalta.
The following Speaker has nothing to disclose with regards to financial relationships: Dr. Sangeeta Jain
The following Planners: Kara Melin and the CME Committee, Amber Murphy, have nothing to disclose with regards to
commercial support.
Target Audience: Physicians and Other Allied Health Professionals
Accreditation Statement:
Roper St. Francis Healthcare designates this live activity for a maximum of 4.0 AMA PRA Category 1 Credit(s)™. Physicians
should claim only the credit commensurate with the extent of their participation in the activity.
Roper St. Francis is accredited by the South Carolina Medical Association to provide continuing medical education for
physicians.
Educational Grant Support:
This activity is supported by an independent educational grant from Shire Immunology, Mylan Inc., Meda, Teva, Sanofi,
AstraZeneca, CVS Specialty-Coram and Novartis, Boston Scientific, CSI Behring, Pronetics/Axelacare Infusion
To Receive CME Credit:
Fill out the evaluation and CME Attestation form given to you as part of the handouts. Turn the form in to the registration desk
at the end of the meeting. A certificate of credit will be emailed to you in 4-6 weeks. If the information on the attestation
form is not filled out, a certificate cannot be issued to you. Please print clearly! If you have questions, please call Kara Melin
in the CME Office at 843-958-1267.
What is it?
Chronic
allergic/inflammatory
condition where
eosinophils are found in
the esophagus
Etiology
• Delayed hypersensitive
reaction to food the
patient is consuming
• Adverse response to pollen
and other airborne
allergens that are being
swallowed
Symptoms
Symptoms can vary by age,
may wax and wane making
it difficult to diagnose
Intractable reflux
Abdominal pain
Difficulty swallowing
Food impactions
Children often have
vomiting, failure to thrive
Foods that can be triggers
 Any
food—may be different for each
person
 Most common dairy (74%)* and wheat
(26%)
 Other common triggers: egg (17%), soy
(10%), nuts, shellfish
*Wechsler et al Journal Asthma and
Allergy 2014
Diagnosis
Symptoms
present
Visual evidence on endoscopy
Biopsies of the esophageal tissue
on endoscopy pathologically
consistent with EoE
Differential Dx of eosinophils in the
esophagus: standard GERD, other
forms of esophagitis, infection, IBD
Determining Triggers
Percutaneous
skin
testing—synthetic or
real food
Blood testing for
specific IgE to foods
Patch testing—Adults
vs children
How effective are
each of these?
Treatment
Elimination
of triggers—empiric
vs. specific
Elemental diets
Medications—corticosteroids,
PPI’s
Dilation
New medications