Natural history of primary eosinophilic esophagitis: a follow-up of 30 adult patients for up to 11.5 years

Straumann, Alex; Spichtin, Hanspeter; Grize, Leticia; Bucher, Kathleen A; Beglinger, Christoph; Simon, Hans‐Uwe

doi:10.1053/j.gastro.2003.09.024

Cited by 663 publications

(622 citation statements)

References 28 publications

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“…5,7,8 Among adults with eosinophilic esophagitis, studies report personal or family histories of allergies ranging from 50 to 90%, including up to 60% with asthma and up to 25% with food allergies. [9][10][11] A disproportionate number of our eosinophilic esophagitis patients also had asthma (at least 15%); our study may underestimate the prevalence of asthma among eosinophilic esophagitis patients, as specific reporting of allergy histories was often omitted from the clinical record.…”

Section: Discussionmentioning

confidence: 93%

“…While many studies have used 415-20 eosinophils/hpf as a diagnostic cutoff, others have used thresholds as low as 45/hpf and as high as 430/hpf (Table 1). 5,[8][9][10][11]13 Rothenberg et al 2,14 suggest that eosinophil counts o7/hpf, 7-24/hpf and 424/hpf indicate gastroesophageal reflux disease, gastroesophageal reflux disease combined with allergy and primary eosinophilic esophagitis respectively. Although eosinophilic esophagitis patients in our study had an average of nearly 40 eosinophils/ hpf, many biopsies showed a patchy distribution and multiple hpfs within a single biopsy often lacked eosinophils.…”

Section: Discussionmentioning

confidence: 99%

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Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients

et al. 2006

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Eosinophilic esophagitis in adults is a recently described entity occurring in young males with dysphagia, in whom esophageal biopsies show eosinophilic infiltration. This study defines the clinical and histological features of patients with eosinophilic esophagitis, distinguishing it from gastroesophageal reflux disease. Esophageal biopsies from patients with dysphagia or esophagitis were reviewed blindly, and assessed for: epithelial eosinophil counts, presence of eosinophilic microabscesses, edema, basal zone hyperplasia, lamina propria papillae elongation, eosinophils and fibrosis. Clinical and endoscopic findings were obtained. Eosinophilic esophagitis was diagnosed with epithelial eosinophils Z15 in Z2 high-power fields (hpfs) or Z25 in any hpf. Analysis was performed with Mann-Whitney, v 2 and ANOVA tests. Of 157 cases, 41 had eosinophilic esophagitis. Male gender (81%) and age r45 (54%) were commoner in patients with eosinophilic esophagitis (P ¼ 0.001, 0.010, respectively). Dysphagia was more common in eosinophilic esophagitis patients (63%, Po0.001); heartburn was more common in noneosinophilic esophagitis patients (53%, Po0.001). Endoscopic rings were more common in eosinophilic esophagitis patients (27%, P ¼ 0.023); hiatus hernia was more common in noneosinophilic esophagitis patients (11%, P ¼ 0.022). Eosinophils were more numerous in eosinophilic esophagitis biopsies (mean 39/hpf, Pr0.001). Only eosinophilic esophagitis biopsies had eosinophilic microabscesses (42%, Pr0.001). Edema, basal zone hyperplasia, lamina propria papillae elongation and lamina propria eosinophils were commoner in eosinophilic esophagitis (P ¼ o0.001-0.002), while lamina propria fibrosis was specific for eosinophilic esophagitis (39%, Po0.001). Eosinophilic esophagitis is a disease with a predilection for young males with dysphagia and rings on endoscopy. Biopsies in eosinophilic esophagitis have high epithelial eosinophil counts, averaging nearly 40/hpf. Increased awareness of eosinophilic esophagitis is necessary, since treatment with allergen elimination or antiinflammatory therapy may be more effective than acid suppression.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients

et al. 2006

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“…[2][3][4][5][6] Adult EoE patients primarily suffer from dysphagia, often culminating in food impaction necessitating endoscopic bolus removal. [7][8][9] The endoscopic presentation of EoE is quite variable. Recently, the endoscopic features of EoE have been graded by Hirano et al [10] For the purposes of this study, characteristic features of EoE were classified into two categories, the inflammatory and the fibrotic group of EoE features.…”

Section: Introductionmentioning

confidence: 99%

Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

Schoepfer

Safroneeva

Bussmann³

et al. 2013

Gastroenterology

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632

517

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“…The American College of Gastroenterology recommends a cut of >15 eosinophils per high power field on the esophageal biopsy in presence of esophageal symptoms that are not responsive to proton pump inhibitors for diagnosis [7]. Very little is known over the natural history of the disease, but current evidence suggests a favorable prognosis [8].…”

Section: Discussionmentioning

confidence: 99%

Infective Esophagitis: Inhaled Steroids Treatment for Eosinophilic Esophagitis not Always Safe

Zala¹,

Wauters²,

Vanuytsel³

et al. 2017

GHOA

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Natural history of primary eosinophilic esophagitis: a follow-up of 30 adult patients for up to 11.5 years

Cited by 663 publications

References 28 publications

Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients

Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients

Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

Infective Esophagitis: Inhaled Steroids Treatment for Eosinophilic Esophagitis not Always Safe

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