Diagnóstico y tratamiento de la esofagitis eosinofílica
DOI:
https://doi.org/10.52787/agl.v55i3.539Palabras clave:
Esofagitis eosinofílica, tratamiento, diagnóstico, endoscopía digestiva, dieta de eliminación, corticoesteroide tópico oral, inhibidor de bomba de protones, dupilumabResumen
Introducción y objetivos. La esofagitis eosinofílica es una enfermedad inflamatoria crónica del esófago mediada por una respuesta inmune tipo 2 y desencadenada principalmente por alérgenos alimentarios. Su incidencia y prevalencia han aumentado de manera significativa en las últimas décadas, convirtiéndose en una causa frecuente de disfagia y obstrucción esofágica. El objetivo de esta revisión narrativa es sintetizar la evidencia actual sobre el diagnóstico y tratamiento de la EEo, con énfasis en aspectos aplicables a la práctica clínica en Latinoamérica.
Material y métodos. Se realizó una revisión narrativa de la literatura publicada en PubMed y bases complementarias hasta mayo de 2025. Se incluyeron estudios originales, revisiones sistemáticas, guías de práctica clínica y consensos internacionales relevantes para el diagnóstico y manejo terapéutico de la EEo.
Resultados. El diagnóstico requiere la integración de la clínica con hallazgos endoscópicos e histológicos, utilizando sistemas estandarizados como los puntajes EREFS y EoEHSS. En cuanto al tratamiento, los inhibidores de la bomba de protones, los esteroides tópicos deglutidos y las dietas de eliminación constituyen las terapias de primera línea. La introducción de agentes biológicos, en particular dupilumab, ha ampliado el espectro terapéutico para pacientes con enfermedad refractaria. La dilatación endoscópica se considera segura y eficaz en casos fibroestenosantes. La vigilancia a largo plazo debe incluir evaluación clínica, endoscópica e histológica, dado que los síntomas no siempre reflejan la actividad inflamatoria.
Conclusión. La EEo es una enfermedad crónica que requiere diagnóstico temprano y manejo integral. A pesar de los avances terapéuticos, persisten desafíos relacionados con la disponibilidad de fármacos específicos, biomarcadores no invasivos y estrategias de seguimiento costo-efectivas, los cuales representan áreas prioritarias de investigación futura.
Citas
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