Эозинофильный гастрит у детей: современное состояние проблемы. Обзор литературных данных: ОБЗОРЫ

Екатерина Леонидовна  Моисейкова; Елена Александровна  Корниенко; Светлана Николаевна  Дроздова; Евдокия Алексеевна  Николаева

doi:10.56871/PED.2026.69.52.007

Eosinophilic gastritis in children: current state of the problem. A review of the literature

REVIEWS

Ekaterina L. Moiseikova Saint Petersburg State Pediatric Medical University https://orcid.org/0009-0000-5043-8965
Elena A. Kornienko Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0003-2743-1460
Svetlana N. Drozdova Saint Petersburg State Pediatric Medical University https://orcid.org/0009-0009-2163-4778
Evdokia A. Nikolaeva Saint Petersburg State Pediatric Medical University https://orcid.org/0009-0001-5244-6675

Keywords:

eosinophilic gastritis eosinophilia anemia hypoalbuminemia eosinophilic infiltration elimination diet topical steroids systemic steroids эозинофильный гастрит эозинофилия анемия гипоальбуминемия эозинофильная инфильтрация элиминационная диета топические стероиды системные стероиды

Abstract

Eosinophilic gastritis is a rare chronic, immune-mediated disorder belonging to the group of eosinophilic gastrointestinal diseases, whose incidence has increased over the past decade, including in children. Eosinophilic gastritis is characterized by nonspecific symptoms of upper gastrointestinal tract involvement and eosinophilic infiltration of the gastric wall at varying depths. The prevalence of eosinophilic gastritis in children is estimated at 7.1–17.6 per 100,000, with a peak incidence at age 5 years. Th2-mediated inflammation induced by food allergens plays a key role in its pathogenesis, as evidenced by its high comorbidity with atopy and the effectiveness of elimination diets. The clinical presentation varies from dyspeptic symptoms with mucosal involvement to signs of pyloric stenosis with muscularis infiltration. Diagnosis is based on histological examination of multiple biopsies (at least four from the corpus and antrum). According to the 2024 consensus, the diagnostic threshold for gastric ulceration is the presence of ≥30 eosinophils per high-power field. Endoscopic findings are often nonspecific, and normal-appearing mucosa does not exclude the diagnosis and requires biopsy even from intact areas. Elemental or empirical elimination diets are considered first-line treatment for young children. Topical (budesonide) or systemic corticosteroids are used to induce and maintain remission. A promising approach is the use of biological therapy, particularly dupilumab (a monoclonal antibody to the IL-4α receptor). Its efficacy in combined forms of eosinophilic gastritis has been demonstrated in several studies. However, its role in isolated eosinophilic gastritis requires clarification in randomized controlled trials. Since eosinophilic gastritis is a rare disease with no pathognomonic clinical symptoms or endoscopic changes, there are currently no uniform standards for diagnosis, differential diagnosis, treatment, or follow-up. Currently, the approach to managing such patients is individualized, taking into account the severity of the condition, which is determined based on a combination of data. Based on an analysis of current literature, this article presents data on the prevalence, pathogenesis, main clinical manifestations, laboratory, endoscopic, and histological changes, and treatment approaches.

Author Biographies

Ekaterina L. Moiseikova, Saint Petersburg State Pediatric Medical University

MD, Ph D, Associate Professor, Department of Pediatrics named after Professor I.M. Vorontsov Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg State Pediatric Medical University; address: 2 Litovskaya str., Saint Petersburg, 194100, Russia

Elena A. Kornienko, Saint Petersburg State Pediatric Medical University

MD, Ph D, Dr Med Sci, Professor, Department of Pediatrics named after Professor I.M. Vorontsov Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg, Russia

Svetlana N. Drozdova, Saint Petersburg State Pediatric Medical University

MD, Ph D, Associate Professor, Department of Pediatrics named after Professor I.M. Vorontsov Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg, Russia

Evdokia A. Nikolaeva, Saint Petersburg State Pediatric Medical University

ResidentDoctor, Department of Pediatrics named after Professor I.M. Vorontsov Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg, Russia

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