Patient characteristics, clinical, endoscopic, and histologic findings in adult eosinophilic esophagitis: A case series and systematic review of the medical literature

Shabana F Pasha, J. K. DiBaise, H. J. Kim, G. De Petris, M. D. Crowell, D. E. Fleischer, Virender K. Sharma

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

The objective of our study is to describe patient characteristics, clinical, endoscopic, and pathologic features and management of adult eosinophilic esophagitis (EE). A retrospective review of adults with EE (20 or more eosinophils per high-power field) diagnosed between 1997 and 2006, and a systematic review of the medical literature was performed. Forty-two patients (31 male; 11 female) had EE. Mean (SD) age at diagnosis was 44 (15.8) years, with highest prevalence (48%) at age 20-39. Predominant symptoms were dysphagia (81%); median duration, 8 years; range, 1-30 years and food impaction (55%). Forty-three percent had allergy or atopy, 36% had asthma, 54% had peripheral eosinophilia, and 10% had a first-degree relative with dysphagia. Endoscopic findings included ringed esophagus (55%), linear furrows (33%), narrow esophagus (10%), normal esophagus (7%), and esophageal strictures (38%). Mean number of dilations was 2 (range, 1-5). There were no perforations, but superficial mucosal tears occurred in 31% of dilations. Nine patients were treated with topical fluticasone with clinical improvement in all four (100%) patients who were seen in follow-up. Pathologic findings included 20 or more eosinophils per high-power field from proximal or mid-esophageal biopsy specimens. A systematic review of 14 studies (11 manuscripts, 2 abstracts, and this case series) with 212 patients showed similar findings. EE should be suspected in young men with unexplained dysphagia or food impaction even in the absence of typical endoscopic findings of rings or corrugations, linear furrows, and narrow esophagus; diagnosis is confirmed by 20 or more eosinophils per high-power field on proximal or mid-esophageal biopsies; EE is associated with allergic or atopic disorders; topical steroids are effective in the management of EE; dilation of esophageal strictures is reasonably safe in EE.

Original languageEnglish (US)
Pages (from-to)311-319
Number of pages9
JournalDiseases of the Esophagus
Volume20
Issue number4
DOIs
StatePublished - Aug 2007

Fingerprint

Eosinophilic Esophagitis
Esophagus
Deglutition Disorders
Eosinophils
Dilatation
Esophageal Stenosis
Biopsy
Food
Manuscripts
Eosinophilia
Tears
Hypersensitivity
Asthma
Steroids

Keywords

  • Dysphagia
  • Endoscopy
  • Eosinophilic esophagitis
  • Esophageal food impaction
  • Esophagus

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Patient characteristics, clinical, endoscopic, and histologic findings in adult eosinophilic esophagitis : A case series and systematic review of the medical literature. / Pasha, Shabana F; DiBaise, J. K.; Kim, H. J.; De Petris, G.; Crowell, M. D.; Fleischer, D. E.; Sharma, Virender K.

In: Diseases of the Esophagus, Vol. 20, No. 4, 08.2007, p. 311-319.

Research output: Contribution to journalArticle

Pasha, Shabana F ; DiBaise, J. K. ; Kim, H. J. ; De Petris, G. ; Crowell, M. D. ; Fleischer, D. E. ; Sharma, Virender K. / Patient characteristics, clinical, endoscopic, and histologic findings in adult eosinophilic esophagitis : A case series and systematic review of the medical literature. In: Diseases of the Esophagus. 2007 ; Vol. 20, No. 4. pp. 311-319.
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