title: Clinical presentation of patients with eosinophilic inflammation of the esophagus.
abstract: BACKGROUND
  Allergic eosinophilic esophagitis (AEE) is defined by a dense infiltrate of eosinophils within the esophageal mucosa and the absence of pathological gastroesophageal reflux.
  
  
  OBJECTIVE
  To characterize a pediatric population with AEE to determine if AEE can be diagnosed based on history; to compare patients with varying degrees of esophageal eosinophilic inflammation to determine if moderate esophageal inflammation is part of a continuum of AEE.
  
  
  METHODS
  Medical records of 112 patients with eosinophils on esophageal biopsy specimens were reviewed. Patients were grouped according to eosinophils per high power field (eos/hpf): group 1 (1-5 eos/hpf, n = 31), group 2 (6-14 eos/hpf, n = 13), and group 3 (> or =15 eos/hpf, n = 68) and compared.
  
  
  METHODS
  University Children's Hospital.
  
  
  METHODS
  Children and adolescents with eosinophils on esophageal mucosal biopsy specimens.
  
  
  METHODS
  Analysis of clinical information.
  
  
  METHODS
  Clinical characterization of patients with esophageal eosinophilia.
  
  
  RESULTS
  There was no significant difference in patient demographics. Patients in groups 2 and 3 had multiple food allergens identified. Patients in group 3 with a positive type I allergic response were significantly younger than those with a negative response (mean, 4.6 years old vs mean, 8.5 years old; P = .0065). In group 2, 3 of 13 patients responded histologically to acid-suppressive therapy, whereas 6 patients had improved histology with corticosteroids; 4 of these 6 patients had not responded histologically to acid-suppression.
  
  
  CONCLUSIONS
  Retrospective study.
  
  
  CONCLUSIONS
  History and clinical presentation were not useful in predicting the severity of histologic esophageal inflammation in this cohort. Patients with moderate esophageal eosinophilia (group 2) exhibited a variable response to medical therapy.
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Sachin
authors.initials: S
authors.lastname: Baxi
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Gupta
authors.forename: Nancy
authors.initials: N
authors.lastname: Swigonski
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Fitzgerald
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004724:Endoscopy; D004802:Eosinophilia / Q000175:diagnosis* / Q000473:pathology; D004804:Eosinophils / Q000473:pathology; D050782:Esophageal pH Monitoring; D004941:Esophagitis / Q000175:diagnosis* / Q000473:pathology; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000473:pathology; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007223:Infant; D007428:Intradermal Tests; D007958:Leukocyte Count; D008297:Male; D009092:Mucous Membrane / Q000473:pathology; D011852:Radioallergosorbent Test; D012189:Retrospective Studies; D013223:Statistics as Topic