Association of eosinophilic inflammation with esophageal food impaction in adults.
BACKGROUND
Esophageal food impaction is a common presentation of eosinophilic esophagitis. The prevalence of eosinophilic esophagitis among patients with food impaction is unknown. To address this, we evaluated clinicopathologic features of adults with food impaction.


METHODS
For a 3-year period, patients from a single, adult, community-based gastroenterology practice with esophageal food impaction were evaluated. Histories were assessed and esophageal biopsy specimens were evaluated by routine and immunohistochemical techniques.


RESULTS
Thirty-one patients with food impaction were evaluated. Seventeen of 31 patients had >20 eosinophils/high power field (HPF) without gender predilection. Thirteen of these 17 patients had been treated with proton pump inhibitors at the time biopsy specimens were obtained. Patients with >20 eosinophils/HPF were significantly younger (mean age 42 +/- 4 years) than patients with <20 eosinophils/HPF (mean age 70 + 3 years). Superficial white exudates and eosinophilic microabscesses in the squamous epithelium were features observed only in patients with >20 eosinophils/HPF. Immunopathologic analysis demonstrated increased CD8 lymphocytes and major basic protein deposition in their squamous epithelium.


CONCLUSIONS
More than half of patients with esophageal food impaction in a primary gastroenterology practice have >20 eosinophils/HPF. Based on clinicopathologic features, a significant number likely have eosinophilic esophagitis.
Desai
Tusar K
TK
Department of Medicine, Beaumont Hospital, Royal Oak, Michigan, USA.
Stecevic
Veslav
V
Chang
Chung-Ho
CH
Goldstein
Neal S
NS
Badizadegan
Kamran
K
Furuta
Glenn T
GT
D000038:Abscess / Q000473:pathology; D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D004802:Eosinophilia / Q000150:complications* / Q000473:pathology; D004804:Eosinophils / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D004941:Esophagitis / Q000150:complications* / Q000473:pathology; D004945:Esophagoscopy; D005122:Exudates and Transudates; D005260:Female; D005500:Follow-Up Studies; D005502:Food; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors
D005765:Gastrointestinal Agents; D054328:Proton Pump Inhibitors