Prevalence of esophageal eosinophils in patients with barrett's esophagus

Karthik Ravi, David A Katzka, Thomas Christopher Smyrk, Prasad G Iyer, Yvonne Romero, Dawn L. Francis, Lori Lutzke, Jianmin Tian, Kenneth Ke Ning Wang

Research output: Contribution to journalArticle

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Abstract

Objectives: Recent studies have demonstrated high esophageal eosinophil counts in patients with GERD similar to eosinophilic esophagitis (EoE) yet the frequency of esophageal eosinophilia in GERD is unknown. Our aim was to determine the prevalence of dense esophageal eosinophilia in patients with Barrett's esophagus as a manifestation of GERD. Methods: The Mayo Clinic pathology database was reviewed for patients diagnosed with Barrett's esophagus from January to December 2008 with squamous mucosa obtained during endoscopic surveillance. Clinical, endoscopic, and histologic findings were reviewed. Patients with 15 eosinophils per high powered field were identified and compared to those without esophageal eosinophilia. Results: Two hundred patients with Barrett's esophagus and squamous tissue obtained at the time of biopsy were identified. Fourteen of the 200 patients (7%) had 15 eosinophils per high powered field. Demographics, symptoms, and proton pump inhibitor therapies were similar between those with and without esophageal eosinophilia. Endoscopic features suggestive of EoE were found in the squamous mucosa of 2 patients with and 7 patients without esophageal eosinophilia. Use of photodynamic, radiofrequency ablation, or monopolar electrocoagulation therapy for ablation of Barrett's mucosa was not associated with a higher rate of esophageal eosinophilia. Basal cell hyperplasia, papillary elongation, and spongiosis occurred frequently in association with esophageal eosinophilic infiltration. Conclusions: High esophageal eosinophil counts were found in 7% of this cohort of 200 patients with Barrett's esophagus and likely underestimates prevalence. The finding of esophageal eosinophilia in this cohort was independent of proton pump inhibitor use, features of EoE, or endoscopic therapy for Barrett's esophagus. Further studies are needed to assess if these findings are applicable to all patients with GERD.

Original languageEnglish (US)
Pages (from-to)851-857
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume106
Issue number5
DOIs
StatePublished - May 2011

Fingerprint

Barrett Esophagus
Eosinophils
Eosinophilia
Eosinophilic Esophagitis
Gastroesophageal Reflux
Mucous Membrane
Proton Pump Inhibitors
Electrocoagulation
Hyperplasia
Therapeutics
Demography
Databases
Pathology
Biopsy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Prevalence of esophageal eosinophils in patients with barrett's esophagus. / Ravi, Karthik; Katzka, David A; Smyrk, Thomas Christopher; Iyer, Prasad G; Romero, Yvonne; Francis, Dawn L.; Lutzke, Lori; Tian, Jianmin; Wang, Kenneth Ke Ning.

In: American Journal of Gastroenterology, Vol. 106, No. 5, 05.2011, p. 851-857.

Research output: Contribution to journalArticle

Ravi, Karthik ; Katzka, David A ; Smyrk, Thomas Christopher ; Iyer, Prasad G ; Romero, Yvonne ; Francis, Dawn L. ; Lutzke, Lori ; Tian, Jianmin ; Wang, Kenneth Ke Ning. / Prevalence of esophageal eosinophils in patients with barrett's esophagus. In: American Journal of Gastroenterology. 2011 ; Vol. 106, No. 5. pp. 851-857.
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abstract = "Objectives: Recent studies have demonstrated high esophageal eosinophil counts in patients with GERD similar to eosinophilic esophagitis (EoE) yet the frequency of esophageal eosinophilia in GERD is unknown. Our aim was to determine the prevalence of dense esophageal eosinophilia in patients with Barrett's esophagus as a manifestation of GERD. Methods: The Mayo Clinic pathology database was reviewed for patients diagnosed with Barrett's esophagus from January to December 2008 with squamous mucosa obtained during endoscopic surveillance. Clinical, endoscopic, and histologic findings were reviewed. Patients with 15 eosinophils per high powered field were identified and compared to those without esophageal eosinophilia. Results: Two hundred patients with Barrett's esophagus and squamous tissue obtained at the time of biopsy were identified. Fourteen of the 200 patients (7{\%}) had 15 eosinophils per high powered field. Demographics, symptoms, and proton pump inhibitor therapies were similar between those with and without esophageal eosinophilia. Endoscopic features suggestive of EoE were found in the squamous mucosa of 2 patients with and 7 patients without esophageal eosinophilia. Use of photodynamic, radiofrequency ablation, or monopolar electrocoagulation therapy for ablation of Barrett's mucosa was not associated with a higher rate of esophageal eosinophilia. Basal cell hyperplasia, papillary elongation, and spongiosis occurred frequently in association with esophageal eosinophilic infiltration. Conclusions: High esophageal eosinophil counts were found in 7{\%} of this cohort of 200 patients with Barrett's esophagus and likely underestimates prevalence. The finding of esophageal eosinophilia in this cohort was independent of proton pump inhibitor use, features of EoE, or endoscopic therapy for Barrett's esophagus. Further studies are needed to assess if these findings are applicable to all patients with GERD.",
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AU - Romero, Yvonne

AU - Francis, Dawn L.

AU - Lutzke, Lori

AU - Tian, Jianmin

AU - Wang, Kenneth Ke Ning

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N2 - Objectives: Recent studies have demonstrated high esophageal eosinophil counts in patients with GERD similar to eosinophilic esophagitis (EoE) yet the frequency of esophageal eosinophilia in GERD is unknown. Our aim was to determine the prevalence of dense esophageal eosinophilia in patients with Barrett's esophagus as a manifestation of GERD. Methods: The Mayo Clinic pathology database was reviewed for patients diagnosed with Barrett's esophagus from January to December 2008 with squamous mucosa obtained during endoscopic surveillance. Clinical, endoscopic, and histologic findings were reviewed. Patients with 15 eosinophils per high powered field were identified and compared to those without esophageal eosinophilia. Results: Two hundred patients with Barrett's esophagus and squamous tissue obtained at the time of biopsy were identified. Fourteen of the 200 patients (7%) had 15 eosinophils per high powered field. Demographics, symptoms, and proton pump inhibitor therapies were similar between those with and without esophageal eosinophilia. Endoscopic features suggestive of EoE were found in the squamous mucosa of 2 patients with and 7 patients without esophageal eosinophilia. Use of photodynamic, radiofrequency ablation, or monopolar electrocoagulation therapy for ablation of Barrett's mucosa was not associated with a higher rate of esophageal eosinophilia. Basal cell hyperplasia, papillary elongation, and spongiosis occurred frequently in association with esophageal eosinophilic infiltration. Conclusions: High esophageal eosinophil counts were found in 7% of this cohort of 200 patients with Barrett's esophagus and likely underestimates prevalence. The finding of esophageal eosinophilia in this cohort was independent of proton pump inhibitor use, features of EoE, or endoscopic therapy for Barrett's esophagus. Further studies are needed to assess if these findings are applicable to all patients with GERD.

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