New times — new diseases (clinical case of eosinophilic esophagitis combined with macroamilasemia

Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. Eosinophilic esophagitis (EoE) is a chronic immune/antigen-mediated disease of the esophagus, clinically characterised by symptoms of esophageal dysfunction and histologically by severe eosinophilic inflammation. Currently, the only reliable method for diagnosing EoE is endoscopy with biopsy. The minimum threshold criterion for the diagnosis of EoE is 15 eosinophils in the field of view at high magnification (standard size ≈0.3 mm2) in the esophageal mucosa. If EoE is suspected, the allergic status should be assessed. First-line therapy for EoE includes an elimination diet, proton pump inhibitors, and topical corticosteroids. EoE has a relatively favourable course (provided timely diagnosis and treatment), as this pathology is not a precancerous condition. Macroamylasemia should be suspected when blood amylase activity is elevated but urine amylase levels are normal and there are no signs of pancreatic or salivary gland pathology. A simple and affordable method of diagnosing macroamilasemia is determining the ratio of amylase and creatinine clearances. Macroamilasemia cannot be treated, but only monitored. If necessary, the disease that may have caused the formation of macroamilasemia is treated. A clinical case of a patient with EoE and macroamylasemia is presented. The ACG’s еvidence-based recommendations for EoE diagnosis, treatment modalities, and patients’ follow up are shown in the article. The article represents definition and forms of macroamylasemia, clinical significance and prognosis.