Low Grade Esophageal Eosinophilia in Adults: An Unrecognized Part of the Spectrum of Eosinophilic Esophagitis?
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Karthik Ravi Nicholas J. Talley Thomas C. Smyrk David A. Katzka Lori Kryzer Yvonne Romero Amindra S. Arora Jeffrey A. Alexander
- چاپ و سال / کشور: 2011
Description
Background Eosinophilic esophagitis (EoE) is defined by a minimum of 15 eosinophils (eos) per high-powered field (HPF) on esophageal biopsy, along with esophageal symptoms and the exclusion of gastroesophageal reflux (GERD). The clinical significance of fewer eosinophils is unknown. Methods Fifty-nine adult patients without a previous diagnosis of EoE with esophageal biopsies containing 1–14 eos per HPF (low grade eosinophilia) and 418 adult patients with C15 eos per HPF were identified by retrospective review. Patients were divided into group A (1–9 eos per HPF), group B (10–14 eos per HPF), and group C (C15 eos per HPF) with a chart review of clinical and demographic data. Results While dysphagia and atopy (asthma and allergic rhinitis) were more common in patients with C15 eos per HPF (group C) than those with low grade esophageal eosinophilia (groups A and B) (93 vs. 88%, P = 0.02), food impaction and heartburn occurred at an equal frequency across all patient groups. Endoscopic findings were likewise similar between groups. Of the 14 patients with low grade esophageal eosinophilia who underwent repeat endoscopy a mean interval of 42 weeks (range 8–118 weeks) later, five (36%) met conventional diagnostic criteria for EoE of 15 or greater eos per HPF. Follow-up in ten patients treated with topical corticosteroids noted improvement in nine, with mean follow-up of 8 weeks (range 4–12 weeks). Conclusion Some adult patients with dysphagia and less than 15 eos per HPF have similar endoscopic findings and clinical course to patients meeting the consensus definition of EoE. Further evaluation of patients with low grade esophageal eosinophilia is needed
Dig Dis Sci (2011) 56:1981–1986 DOI 10.1007/s10620-011-1594-1 Received: 18 November 2010 / Accepted: 21 January 2011 / Published online: 6 February 2011
