Eosinophilic esophagitis in an octogenarian

Abstract

Introduction:Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by a marked eosinophilic infiltrate in the esophageal mucosa. What was once considered a rare disease has nowadays become one of the most frequent esophageal diseases in the Western countries, occupying a place just next to the gastroesophageal reflux disease. EoE etiology and pathogenesis remain largely unknown, although most studies consider that allergic and genetic factors play the most important role.Methods:We report the case of EoE in an elderly male (octogenarian), giving a brief review of the current data related to epidemiology, pathogenesis, diagnosis, and treatment of the disease.Results:Dysphagia to solid foods was the leading symptom, and endoscopic findings included white exudates, longitudinal furrows, and concentric mucosal rings, all suggestive for EoE. Diagnosis relied on histological findings in esophageal mucosal biopsies (>30 eosinophils per high power field).He was treated with topical steroids for 8 weeks, symptoms improved gradually and the patient remained in remission at the 8-month follow-up.Conclusion:This case emphasizes that EoE may occur in very old patients and gastroenterologists should have a high index of suspicion of this disorder in any elderly with dysphagia and endoscopic relevant features.

Eosinophilic Esophagitis in the Setting of Prior Caustic Ingestion

“…EoE is a chronic immune-mediated disease characterized by marked eosinophilic infiltration of the esophageal mucosa (≥15 eosinophils per high-power field of view). Fibrosclerotic changes due to inflammation lead to the narrowing of the esophagus and dysphagia [ 6 ].…”

Gastroesophageal Reflux Disease and Complications

“…Eosinophilic esophagitis (EE), an inflammatory condition of the esophagus caused by eosinophilic infiltration of the esophageal mucosa, can also present with GERD-like symptoms. EE has a bimodal incidence with high incidence in adults and elderly (Trifan et al 2016). Gastroenterologists and geriatricians should have high suspicion of EE in adults and elderly presenting with chronic persistent heartburn and dysphagia refractory to PPI use.…”