Abstract
Eosinophilic esophagitis (EoE) is a clinicopathologic condition of increasing recognition and prevalence. Because of elevated total IgE levels and high rates of concurrent allergic diseases compared with the general population, EoE appears to be an antigen-driven immunologic process that caused by allergens like food or aeroallergens. EoE is a disease that features dense intraepithelial infiltration by eosinophils which cause excessive mucosal immunologic reactions which cause several symptoms that mostly involve dysphagia. For establishment of the diagnosis, infiltration of eosinophils (≥ 20 eosinophils/HPF) should be identified in an esophageal mucosal biopsy specimen. In treatment of patients have a possibility of EoE, proton-pump inhibitors(PPIs) must be tried as first choice. Other proved therapeutic options include topical or systemic corticosteroids, chronic dietary elimination, and esophageal dilation, but local administration of glucocorticoids has recently been reported as useful therapy for EoE.
Highlights
Eosinophilic esophagitis (EoE) is currently defined as a chronic immune-mediated condition where infiltration of eosinophils into the esophageal mucosa leads to symptoms of esophageal dysfunction.[1]
Eosinophilic esophagitis is a chronic allergen-mediated disorder defined by symptoms of esophageal dysfunction and epithelial eosinophilia on biopsy
It has rapidly emerged as an important cause of upper GI morbidity in patients of all ages and is encountered in a substantial proportion of patients undergoing diagnostic upper endoscopy
Summary
Eosinophilic esophagitis (EoE) is currently defined as a chronic immune-mediated condition where infiltration of eosinophils into the esophageal mucosa leads to symptoms of esophageal dysfunction.[1]. There are some data to suggest that younger children tend to have more inflammatory features such as linear furrows, white plaques, and decreased vasculature, while adults ( those with a long symptom duration) tend to have more fibrotic features such as rings and strictures.[8,59,60] It is important to note that the endoscopic findings of EoE are not pathognomonic, and a recent meta-analysis found that the sensitivity, specificity, and predictive values of endoscopic findings in EoE were not high enough to be the basis for diagnostic decisions This emphasizes the importance obtaining esophageal biopsies when EoE is suspected clinically. If they have failed dietary therapy, they should be placed on topical steroids
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