Eosinophilic oesophagitis and proton pump inhibitor‐responsive oesophageal eosinophilia have similar clinical, endoscopic and histological findings

Abstract

SUMMARY BackgroundSome patients with a phenotypic appearance of eosinophilic oesophagitis (EoE) respond histologically to PPI, and are described as having PPI-responsive oesophageal eosinophilia (PPI-REE). It is unclear if PPI-REE is a GERDrelated phenomenon, a subtype of EoE, or a completely unique entity.

Systematic review of histological remission criteria in eosinophilic esophagitis

“…Nonetheless, four studies considered remission within the range of 0 to ≤5 eosinophils/hpf, 42, 43, 44, 45 and five studies considered remission as having ≤15 eosinophils/hpf 46, 47, 48, 49, 50…”

Editorial: is eosinophilic oesophagitis different to proton pump inhibitor‐responsive oesophageal eosinophilia?

“…Basophil and mast cell epithelial infiltration was significantly higher in both groups, but not in gastrooesophageal reflux (GERD) patients or control subjects. Several recent studies [2][3][4][5][6][7][8] have failed to find distinguishing features between EoE and PPI-REE (Table 1). The study by Iwakura et al 1 aligns with the evolving concept that both entities share the same pathogenesis.…”

Commentary: the proton pump inhibitor test – does it have a role in eosinophilic oesophagitis?

“…1 The latter group is termed PPI-responsive oesophageal eosinophilia. Interestingly, despite symptomatic and histological response to PPI, the two patient groups were similar in almost all demographic, histological and clinical parameters that were assessed in this study.…”

“…Patients treated with at least 6 weeks of twice-daily PPI were included. 1 It is possible that some of the EOE patients may require a longer duration of treatment (up to 3 months), before full response to PPI could be achieved. In addition, comparison with nontreated EOE patients could have helped to determine the contribution of the natural course of the disease to fluctuations in oesophageal eosinophilic count.…”

“…1 To address their first comment, 2 the sample size of our study was relatively small because we focused on cases of oesophageal eosinophilia diagnosed since the publication of the 2011 consensus statement, in which proton pump inhibitor responsive oesophageal eosinophilia (PPI-REE) was formally recognised. 3 Our study was retrospective in design; however, the data from both study sites were obtained from clinical databases, which are carefully maintained by the authors who prospectively enrol and collect data on patients with eosinophilic oesophagitis (EoE) and PPI-REE.…”