title: Eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease.
abstract: BACKGROUND
  Eosinophilic esophagitis is among the causes of refractory reflux disease. Biopsy of esophagus is the gold standard for diagnosis. In this study we determined the frequency of eosinophilic esophagitis (EE) in refractory reflux cases referred to Motility Department of Shahid Beheshti Research Center of Gastroenterology and Liver Disease, Tehran, Iran.
  
  
  METHODS
  In this cross-sectional study, 68 cases with refractory reflux disease underwent endoscopy and had biopsies taken. Specimens were stained by hematoxylin and eosin and two independent pathologists confirmed the diagnosis of eosinophilic esophagitis.
  
  
  RESULTS
  Mean (standard deviation, SD) age at diagnosis was 41.8 (10.94) years. All had allergy or atopy, and unknown dysphagia was noted for 66%. Endoscopic findings were as follows: esophagitis (33.3%), rings (33.3%), and whitish plaques (33.3%). Prevalence of eosinophilic esophagitis was 8.8% (N = 6; one man and five women). No statistical difference in demographic variables was found between eosinophilic esophagitis cases and others, except for history of atopy, food impaction, and endoscopic features (P value <0.005).
  
  
  CONCLUSIONS
  Eosinophilic esophagitis should be considered in the differential diagnosis of any cases with refractory reflux who complain of chronic unexplained dysphagia, with history of recurrent food impaction, and atopy or abnormal endoscopic features.
authors.affiliation: Digestive Disease Research Center of Shahid Beheshti University of Medical Sciences, P.O. Box 13185-1678, Tehran, Iran. swt_f@yahoo.com
authors.forename: Mojgan
authors.initials: M
authors.lastname: Foroutan
authors.forename: Alireza
authors.initials: A
authors.lastname: Norouzi
authors.forename: Mahsa
authors.initials: M
authors.lastname: Molaei
authors.forename: Seyed Amir
authors.initials: SA
authors.lastname: Mirbagheri
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Irvani
authors.forename: Amir
authors.initials: A
authors.lastname: Sadeghi
authors.forename: Faramarz
authors.initials: F
authors.lastname: Derakhshan
authors.forename: Samaneh
authors.initials: S
authors.lastname: Tavassoli
authors.forename: Sima
authors.initials: S
authors.lastname: Besharat
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Zali
mesh_terms: D000328:Adult; D004802:Eosinophilia / Q000150:complications* / Q000175:diagnosis*; D004941:Esophagitis / Q000150:complications* / Q000175:diagnosis; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications; D008297:Male