Amanda Muir (Muir Lab) @LabMuir
Assistant Professor of Pediatrics, Children’s Hospital of Philadelphia/UPenn. Eosinophilic esophagitis (EoE), fibrosis and epithelial homeostasis Joined October 2019-
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@RSanchez490MD @PedsGIChat @dr_rdvenkatesh I use it to find the narrowest point as well as to help me decide which balloon size to use at the beginning of the dilation. Thanks for the question! #EndoFLIP
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@PedsGIChat @dr_rdvenkatesh @pedsgidoctora There are times where we will do a slow introduction of milk, beginning with baked and then starting regular milk. This may helps kids have a less restrictive diet if restricted.
@PedsGIChat There are studies trying to identify #biomarkers, less invasive ways of monitoring disease, trials to figure out the exact food. There are also several biologics in development. The esophageal string test is a non-invasive way to gather esophageal secretions and detect EoE.
@MohammadDwi33 @PedsGIChat @bowelsounds @dr_rdvenkatesh Great question! That would be a good study. Because diagnosis relies on endoscopy, access to pediatric gastroenterologist can be an obstacle.
@PedsGIChat Check this out: pubmed.ncbi.nlm.nih.gov/36000828/
@PedsGIChat There is evidence that aeroallergens cause esophageal eosinophilia. Aeroallergens may cause EoE exacerbations and patients may need management of rhinitis during certain seasons. It is likely a rare entity that remains mostly discussed in case reports.
@PedsGIChat It allows the physician to monitor diameter and distensibility overtime and assess for subtle narrowing that may not be picked up by regular endoscopy.
@PedsGIChat Its nice to start with #PPI as it is safe and effective and can get about 40% of kids into remission.
@PedsGIChat annallergy.org/article/S1081-… This expert guideline shares some clinical scenarios where #dupilumab should be considered.
@PedsGIChat It has been nearly a year since its official @US_FDA approval for EoE, however, there are no defined criteria carved out in the literature yet. It should be considered for those patients with multiple comorbid atopic conditions, refractory to current therapy, poor compliance
@RSanchez490MD @PedsGIChat @dr_rdvenkatesh Fungal esophagitis can occur in a small number of patients but is treatable (<10%). And in kids who are on many topical steroids (inhaled/topical) it is good to keep an eye on AM cortisol
@PedsGIChat If in mucosal remission, could attempt to wean to half dose and then rescope in 12-16 weeks. If discontinuing, would recommend pivoting to another treatment.
@PedsGIChat Based on a repeat endoscopy, if an #EoE patient does not have mucosal improvement, would recommend discontinuation of a #PPI. Or potentially attempting to wean once a patient has achieved mucosal remission.
@PedsGIChat @ChildrensPhila @nationwidekids @NASPGHAN Thank you so much for having me! Excited to talk about #EoE
Amanda Muir (Muir Lab) retweeted
🚨New #peds #GITwitter Chat 💻Join the 💬 this #Thursday as we dive into the management of #EoE with Dr. Muir &Dr Venkatesh #MedTwitter @NMGastro @NMEsophagi @CharityEos @EosinophilicC @eosinophilsoc @eosinophils @curedfoundation @LabMuir @dr_rdvenkatesh @temarahajjat
Amanda Muir (Muir Lab) retweeted
🎙New Episode Alert 🚨 ➡️Dr. Amanda Muir talks Tx of #EoE w/Drs. @temarahajjat & @PLLU ✅PPI? Steroids? Dietary therapy? Dupilumab? ✅#Endoflip 🎧Tune in to learn about the latest Tx insights @LabMuir @ChildrensPhila @eosinophils @NMEsophagi @CharityEos @EosinophilicC
Congrats to @lab_hill on his stellar talk on the role of T cells in EGIDs at @AAAAI_org. #eoe #egid
Amanda Muir (Muir Lab) retweeted
Last week we were able to honor the amazing work Dr. Jonathan Spergel has done at @ChildrensPhila at our inaugural Honor Your Doctor event. Thanks to all the doctors across the country who make a positive impact on families with #foodallergies.
Had a wonderful time discussing fibrosis in #EoE with the Inflammation and Immunity folks at ClevClinic. Big thanks to @IBD_FloMD
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