Clinical presentation of patients with eosinophilic inflammation of the esophagus.
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.
Baxi
Sachin
S
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Gupta
Sandeep K
SK
Swigonski
Nancy
N
Fitzgerald
Joseph F
JF
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