Histopathologic Features of Eosinophilic Esophagitis

Collins, Margaret H.

doi:10.1016/j.giec.2007.09.014

Cited by 119 publications

(109 citation statements)

References 56 publications

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“…Gastroesophageal reflux-associated esophagitis was excluded using the Ismail-Beigi criteria [18] modified by Vieth et al [19]. According to Collins [20], EoE was diagnosed based on major features such as increased intraepithelial eosinophils (≥15 per high-power field of 0.55 mm 2 in areas of peak density), eosinophilic microabscesses, aggregates of eosinophils in the epithelial surface layers, degranulation of eosinophils, and surface sloughing of epithelial cells and eosinophils in ≥2 biopsies (levels).…”

Section: Methodsmentioning

confidence: 99%

Identification of Clinical and Laboratory Markers for Predicting Eosinophilic Esophagitis in Adults

Arnim

Wex²,

Röhl³

et al. 2011

Digestion

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Background: The diagnosis of eosinophilic esophagitis (EoE) and differentiation from gastroesophageal reflux disease (GERD) is potentially challenging and is based upon clinical signs and endoscopic and histological features. In order to alert the endoscopist to consider EoE in patients with esophageal symptoms before performing esophagogastroduodenoscopy, we aimed to identify a set of clinical and laboratory markers for predicting EoE. Methods: The study included 43 patients with either EoE (n = 23) or GERD (n = 20). The diagnosis of EoE was based on International Consensus Criteria. Age, gender, weight loss, history of atopy, dysphagia, history of food impaction, proton pump inhibitor (PPI) refractory heartburn, odynophagia, peripheral eosinophilia, and serum IgE were analyzed. Each symptom or sign was classified as ‘0’ (absent, normal) or ‘1’ (present, elevated), individually analyzed and statistically evaluated among the two groups of patients. Logistic regression analysis was carried out to identify a clinically applicable marker constellation to differentiate EoE from GERD. Results: Univariate analysis identified 6 out of the 10 variables to be significant between both groups. A stepwise procedure of logistic regression led to a model in which 3 out of the initial 10 items were found to be relevant for differentiating GERD and EoE. Derived from this model, an optimal differentiation was achieved by using the following simplified equation: peripheral eosinophilia + history of food impaction + PPI refractory heartburn leading to a maximal value of 3 (1 + 1 + 1). Based on a cut-off value of ≧2, sensitivity and specificity for diagnosing EoE were 91 and 100%, respectively. Conclusion: A defined set of markers including two clinical features and one laboratory parameter is highly predictive of EoE and thus allows physicians to distinguish EoE from GERD even before upper gastrointestinal endoscopy is performed.

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Section: Methodsmentioning

confidence: 99%

Identification of Clinical and Laboratory Markers for Predicting Eosinophilic Esophagitis in Adults

Arnim

Wex²,

Röhl³

et al. 2011

Digestion

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“…Visual inspection of the esophageal mucosa can reveal one or more findings,12 including furrows, white plaques and loss of vascular pattern, all common in the pediatric population. While the cause of furrows is unclear, white plaques are formed by aggregates of eosinophils closest to the luminal surface associated with some sloughing of the superficial epithelial cells 13. In addition, esophageal rings, strictures, narrowing, or even shearing can be present in more severe cases.…”

Section: Diagnosismentioning

confidence: 99%

In time: Eosinophilic esophagitis: when to suspect it and how to diagnose it in children and adolescents

Chehade

2016

Revista Paulista de Pediatria (English Edition)

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“…61,62 Other histologic features include eosinophilic microabscesses (clusters of > 4 eosinophils), superficial layering of eosinophils, extracellular eosinophilic granules (comprising of eosinophil peroxidase, major basic protein and eosinophilic derived neurotoxin), rete peg elongation, basal cell hyperplasia, and lamina propria fibrosis. 63,64 158 …”

Section: Histological Features (Figure 2)mentioning

confidence: 99%

Eosinophilic esophagitis

Kedia¹

2015

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Eosinophilic esophagitis (EoE) is a clinico-pathological entity characterised by symptoms of esophageal dysfunction and eosinophilia on esophageal mucosal biopsies in the absence of other causes of esophageal eosinophilia. It is a chronic inflammatory condition of esophagus often characterized by refractory reflux symptoms in children and dysphagia in adults. It occurs as a result of Th2 inflammatory response to environmental triggers (food antigens) in genetically predisposed individuals. The diagnostic criteria include symptoms of esophageal dysfunction, esophageal eosinophilia (> 15/hpf), and a PPI trial (persistent eosinophilia after 8 weeks of PPI). Mainstay of treatment at present is topical steroids and dietary therapy.Maintenance treatment should be considered to prevent long term complications.

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Histopathologic Features of Eosinophilic Esophagitis

Cited by 119 publications

References 56 publications

Identification of Clinical and Laboratory Markers for Predicting Eosinophilic Esophagitis in Adults

Identification of Clinical and Laboratory Markers for Predicting Eosinophilic Esophagitis in Adults

In time: Eosinophilic esophagitis: when to suspect it and how to diagnose it in children and adolescents

Eosinophilic esophagitis

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