Characteristics Of Eosinophilic Esophagitis Research Articles

Similarity and difference in the characteristics of eosinophilic esophagitis between Western countries and Japan.

Over the past two decades, the incidence and prevalence of eosinophilic esophagitis (EoE) have risen rapidly, especially in Western countries, with cases in Japan also showing a gradual increase in recent years. However, similarities and differences regarding the characteristics of EoE between Western countries and Japan remain to be clearly elucidated. The current clinical guidelines for diagnosis include symptoms related to esophageal dysfunction and dense eosinophilic infiltration in the esophageal epithelium. Most affected patients in Japan are diagnosed incidentally during a medical health check-up and asymptomatic cases with typical endoscopic findings suggestive of EoE are frequently encountered. Clinical characteristics of EoE in Japanese are similar to those seen in Western populations. The predominant symptom is dysphagia, with food impaction extremely rare in Japanese cases. Linear furrows are the most frequently reported characteristic endoscopic finding, while an esophageal stricture or narrow caliber is rarely observed. Treatment strategies for EoE include drugs, dietary restrictions, and endoscopic dilation when the disease is advanced with stricture formation. Although single therapy using a proton-pump inhibitor has been shown to achieve symptomatic and histological response in the majority of patients in Japan, no prospective randomized control studies that evaluated drug or elimination diet therapy have been presented. Overall, EoE has similar clinical characteristics between Japanese and Western populations, while disease severity seems to be milder in Japan. Additional studies are necessary to determine genetic factors, natural history of the disease, and treatment efficacy of drugs and elimination diet as compared to Western populations.

Mo1154 – Prevalence and Characteristics of Eosinophilic Esophagitis in the Community: Results from a Population-Based Survey

Mo1154 – Prevalence and Characteristics of Eosinophilic Esophagitis in the Community: Results from a Population-Based Survey

Assessing the incidence trend and characteristics of eosinophilic esophagitis in children in Olmsted County, Minnesota.

Previous studies reported increased eosinophilic esophagitis (EoE) incidence in children. It is unclear whether this reported increased EoE incidence is true or due to increased recognition and diagnostic endoscopy among children. A population-based study that evaluated EoE incidence in OC, Minnesota, from 1976 to 2005 concluded that EoE incidence increased significantly over the past three 5-year intervals (from 0.35 [range: 0-0.87] per 100,000 person-years for 1991-1995 to 9.45 [range: 7.13-11.77] per 100,000 person-years for 2001-2005). The aim of this study is to assess the change of incidence and characteristics of EoE in children in the same population between 2005 and 2015 and compare the findings to those reported in the previous study. We retrospectively reviewed the electronic medical records from Olmsted Medical Center and Mayo Clinic between 2005 and 2015, using Rochester Epidemiology Project (REP) resources. All children with EoE diagnosis based on the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) guidelines were included. The incidence and characteristics of children with EoE during the study period were compared to those diagnosed between 1995 and 2005. The incidence of EoE in children adjusted for age and sex was 5.31 per 100,000 population person-years in 1995, 15.2 in 2005, and 19.2 in 2015. Change in annual incidence and seasonal variation were not significant, (P=.48) and (P=.32), respectively. Between 2005 and 2015, 73 children received an EoE diagnosis (boys 49; 67%) compared to 16 children (boys 10; 62.5) between 1995 and 2005. Mean (SD) age at diagnosis was 7.5 (5.2) and 12.8 (4.3) years, respectively. Symptoms differed by age of presentation, with vomiting the most common in children younger than 5 years (41.1% and 43.5%) and dysphagia in those older than 5 years (35.6% and 60.9%). The incidence of EoE was not increased for any specific age-group during the study period (P=.49). This study showed increased incidence of EoE in children in Olmsted County between 2005 and 2015 compared to the incidence between 1995 and 2005 (5.31 per 100,000 population person-years in 1995, 15.2 in 2005, and 19.2 in 2015). However, between 2005 and 2015, the change of incidence was not statically significant, (P=.48) despite the steady increase of EGD performed during the same time frame (64 in 2005 to 144 in 2015). By comparing children diagnosed between 2005 and 2015 to those diagnosed between 1995 and 2005, the mean age at diagnosis was younger in the former group, 7.5 versus 12.8 years. Vomiting replaced dysphagia as the most common clinical presentation. Otherwise, the presenting symptom of EoE in children remained consistent across specific age groups.

P309 Characteristics of eosinophilic esophagitis in African-American preschoolers: a case series

P309 Characteristics of eosinophilic esophagitis in African-American preschoolers: a case series

Eosinophilic Esophagitis in Children and Its Relationship with Parental Allergies: Texas Children's Hospital Experience.

Eosinophilic esophagitis (EoE) is an allergen-mediated, clinicopathological condition affecting all ages. The characteristics of children with EoE in the southwestern USA have not been fully described. Furthermore, very little is known about the relationship between parental allergies and risk of EoE in their offspring in this patient population. To characterize children with EoE and to examine the relationship between prevalence of parental allergies and occurrence of EoE in their offspring at a single referral pediatric center in the southwestern USA. Demographic and clinical information of 126 children (≤18 years of age) with EoE was abstracted in a pre-determined data extraction form and analyzed. The allergy history was collected from biological parents of 61 children (parent-child cluster) with EoE in a standardized questionnaire and analyzed. The median age at presentation was 8 years (interquartile range 4-13). The majority of our patients were male (71 %) and Caucasian (59 %). Overall, 84 % of children reported allergies. Prevalence of food allergy was significantly higher compared to environmental allergies (P = 0.001). At least 46 % of parents reported allergies. A significantly higher proportion of fathers had developed allergies during their childhood compared to adulthood (P = 0.03). The characteristics of EoE in our patients were similar to those reported from other parts of the country. Childhood onset of paternal allergies appears to be a risk factor for occurrence of EoE in their offspring. Additional research to elucidate the relationship between parental allergies and occurrence of EoE in their offspring is warranted.

Systematic review: Eosinophilic esophagitis in Asian countries.

To investigate the prevalence and the clinical characteristics of Asian patients with eosinophilic esophagitis. We conducted a systematic search of the PubMed and Web of Science databases for original studies, case series, and individual case reports of eosinophilic esophagitis in Asian countries published from January 1980 to January 2015. We found 66 and 80 articles in the PubMed and Web of Science databases, respectively; 24 duplicate articles were removed. After excluding animal studies, articles not written in English, and meeting abstracts, 25 articles containing 217 patients were selected for analysis. Sample size-weighted mean values were determined for all pooled prevalence data and clinical characteristics. The mean age of the adult patients with eosinophilic esophagitis was approximately 50 years, and 73% of these patients were male. They frequently presented with allergic diseases including bronchial asthma, allergic rhinitis, food allergy, and atopic dermatitis. Bronchial asthma was the most frequent comorbid allergic disease, occurring in 24% of patients with eosinophilic esophagitis. Dysphagia was the primary symptom reported; 44% of the patients complained of dysphagia. Although laboratory blood tests are not adequately sensitive for an accurate diagnosis of eosinophilic esophagitis, endoscopic examinations revealed abnormal findings typical of this disease, including longitudinal furrows and concentric rings, in 82% of the cases. One-third of the cases responded to proton pump inhibitor administration. The characteristics of eosinophilic esophagitis in Asian patients were similar to those reported in Western patients, indicating that this disease displays a similar pathogenesis between Western and Asian patients.

Racial disparity in eosinophilic esophagitis from a single, defined population

Eosinophilic esophagitis (EoE) is an immune-mediated disease of the esophagus characterized by esophageal eosinophilia and symptoms of esophageal dysmotility. 1 Liacouras C.A. Furuta G.T. Hirano I. et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011; 128: 3 Abstract Full Text Full Text PDF PubMed Scopus (1546) Google Scholar , 2 Assa’ad A.H. Putnam P.E. Collins M.H. et al. Pediatric patients with eosinophilic esophagitis: an 8-year follow-up. J Allergy Clin Immunol. 2007; 119: 731-738 Abstract Full Text Full Text PDF PubMed Scopus (272) Google Scholar Studies have attempted to define the epidemiology of the disease, with most reports suggesting EoE has a predominance in white individuals. 2 Assa’ad A.H. Putnam P.E. Collins M.H. et al. Pediatric patients with eosinophilic esophagitis: an 8-year follow-up. J Allergy Clin Immunol. 2007; 119: 731-738 Abstract Full Text Full Text PDF PubMed Scopus (272) Google Scholar , 3 Franciosi J.P. Tam V. Liacouras C.A. Spergel J.M. A case–control study of sociodemographic and geographic characteristics of 335 children with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2009; 7: 415-419 Abstract Full Text Full Text PDF PubMed Scopus (96) Google Scholar , 4 Sperry S.L. Woosley J.T. Shaheen N.J. Dellon E.S. Influence of race and gender on the presentation of eosinophilic esophagitis. Am J Gastroenterol. 2012; 107: 215-221 Crossref PubMed Scopus (76) Google Scholar However, a few recent studies have shed light on this disease in the African American population. 5 Weiler T. Mikhail I. Singal A. Sharma H. Racial differences in the clinical presentation of pediatric eosinophilic esophagitis. J Allergy Clin Immunol Pract. 2014; 2: 320-325 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar , 6 Gill R.K. Al-Subu A. Elitsur Y. et al. Prevalence and characteristics of eosinophilic esophagitis in 2 ethnically distinct pediatric populations. J Allergy Clin Immunol. 2014; 133: 576-577 Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar These reports have suggested that the disease may have different clinical presentations between racially distinct populations and that the incidence in the African American population may be higher than reported from prior studies. It is difficult to know whether there is truly a racial disparity in the prevalence of the disease.

Characteristics Of Eosinophilic Esophagitis Among Children Living In Rural, Southern United States

Characteristics Of Eosinophilic Esophagitis Among Children Living In Rural, Southern United States

Prevalence and characteristics of eosinophilic esophagitis in 2 ethnically distinct pediatric populations

Prevalence and characteristics of eosinophilic esophagitis in 2 ethnically distinct pediatric populations

Physiological characteristics of eosinophilic esophagitis

Physiological characteristics of eosinophilic esophagitis

Su1134 Prevalence and Characteristics of Eosinophilic Esophagitis in Rural Versus Urban Populations

Su1134 Prevalence and Characteristics of Eosinophilic Esophagitis in Rural Versus Urban Populations

Epidemiology and Clinical Characteristics of Eosinophilic Esophagitis in Korea: Based on Single Center Endoscopic Database

Background: Eosinophilic esophagitis (EoE) has been found to be one of the most common diseases among patients complaining of dysphagia and food impaction in western countries. Its epidemiology in Asia has not been clearly defined. We aimed to investigate the epidemiology and clinical characteristics of EoE in Korea using an endoscopic data base at a large tertiary care center. Methods: From January 2006 to October 2010, patients who underwent esophagogastroduodenoscopy (EGD) and esophageal biopsy at a tertiary center were identified. After review of slides by two well-experienced GI pathologists, the mean number of eosinophils (eos) per high power field (HPF) was counted using Olympus BX51 microscopy. Clinical data and endoscopic photographs were reviewed by an advanced esophagologist. Results: A total of 214438 patients underwent EGD. Among them, 6 patients (M:F=5:1, mean age= 44±13, mean eos/HPF:50.2±21.9) were found to have more than 15 eos/HPF and diagnosed with EoE. Two patients (M:F=1:1, mean eos/HPF: 12.5±0.7) showed borderline (514 eos/HPF) eosinophil infiltration. Indications for EGD in EoE patients were dyspepsia (n= 3), dysphagia (n=2) and food impaction (n=1). The endoscopic finding were feline (n= 4), speckled with white spots (n= 1), and normal (n= 1) esophagus. Two of 6 (33%) patients had a history of allergies. Conclusions: In spite of a rapidly growing number of EoE cases in western countries, the number of patients diagnosed with EoE in Korea is still remarkably low. Despite a gradual decrease in annual endoscopic volumes, the percent of patients in whom esophageal biopsies are collected has increased over the past 5 years; as has the number of patients diagnosed with EoE. Standardized, prospective data collection is needed to distinguish between the role of endoscopist awareness and hence, the frequency with which esophageal biopsies are collected, compared to the role of epidemiologic risk factors on the prevalence of EoE in Asia. Trend of Diagnosis of Eosinophilic Esophagitis (EoE)

S1094 Limited Accuracy of Upper GI Studies in the Diagnosis of Eosinophilic Esophagitis in Adults

INTRODUCTION: Endoscopy (EGD) has high sensitivity and specificity in the diagnosis of eosinophilic esophagitis (EoE). Prior case series in EoE have detected abnormalities on upper GI studies (UGI) but the sensitivity of these findings is unknown. AIM: Evaluate the accuracy of UGI in the diagnosis of EoE and compare UGI findings with EGD features. METHODS: A single center adult EoE database identified patients (pts) with prior UGI. Initial UGI reports, EGD data and unblinded, re-evaluation of UGI images by a senior GI radiologist were compared. RESULTS: From 419 EoE pts, 59 (14%) pts with UGI were analyzed. EoE pts with UGI included 36 males with mean age of 40 years. UGI indications included: dysphagia (80%), known diagnosis of EoE (15%) and miscellaneous (abdominal pain and anemia;5%). Mean time between UGI and EGD was 56 days, excluding 13 pts with > 1.5 years between studies. Initial UGI results were classified into 5 categories: normal (15%), findings characteristic of EoE (rings/furrows/exudates; 0%), findings possibly consistent with EoE (stricture/barium tablet retention; 36%), features consistent with GERD (28%), and miscellaneous (hiatal hernia/Schatzki ring/tertiary contractions; 20%). EGD detected characteristic EoE abnormalities in 85% of pts. On re-evaluation of UGI studies by a radiologist, the detection rate of EoE features improved; however the sensitivity for rings and furrows was lower than EGD (Figure, *p<0.05). UGI re-evaluation demonstrated: normal (4%), characteristics of EoE (41%), possibly consistent with EoE (13%), GERD (26%), and miscellaneous (15%). Strictures were detected by UGI in 47% compared with 28% by EGD (NS). CONCLUSIONS: While commonly used as a diagnostic test for dysphagia, UGI studies have limited sensitivity for the diagnosis of EoE in adults. Characteristic features of rings and furrows are better detected on EGD than UGI. Radiologist's awareness of EoE increases the diagnostic yield of UGI detection of EoE features.

Incidence and characteristics of eosinophilic esophagitis in adults

Eosinophilic esophagitis (EE) is a disease characterised by the infiltration of esophageal mucous by eosinophils, whose incidence in adults seems to have been increasing in recent years, in a way that is similar to what is occurring with other diseases of a probable immunoallergic aetiology. It predominates in young adults and is mainly expressed by dysphagia and esophageal food impactation. Treatment is based on eliminating the allergen that is potentially involved and the administration of corticoids. This article offers a retrospective review of EE cases diagnosed in the Hospital de Navarra between January 2002 and August 2008, with 25 patients found, which represents an incidence of 2.13 cases/105 inhabitants/year. Seventy-two percent of our patients showed dysphagia and 52% a history of food bolus impaction, with endoscopic alterations found in 23 of the 25 cases. Out of 24 patients studied, 76% showed an alimentary allergy or neumoallergens, which supports the immunoallergic basis of the disease and the need for an allergy exam in all patients with EE. The majority of our patients (22 out of 24 evaluated) presented a good clinical response to treatment, which was based on avoiding exposure to the potentially involved allergen and/or the administration of corticoids (topical or systemic) and/or the administration of proton pump inhibitors.

S1973 Differences in Demographic and Clinical Characteristics of Eosinophilic Esophagitis in Urban and Rural U.S. Populations

S1973 Differences in Demographic and Clinical Characteristics of Eosinophilic Esophagitis in Urban and Rural U.S. Populations