title: Esophageal intraepithelial eosinophils in dysphagic patients with gastroesophageal reflux disease.
abstract: BACKGROUND
  Patients with gastroesophageal reflux disease (GERD) often complain of dysphagia and are frequently found to have intraepithelial eosinophils on esophageal biopsy.
  
  
  OBJECTIVE
  The aim of this study was to investigate the relationship between dysphagia and the number of intraepithelial eosinophils in patients with GERD.
  
  
  METHODS
  Review of all patients studied in our esophageal function laboratory from 1999 to 2007 identified 1,533 patients with increased esophageal acid exposure. Patients who complained of dysphagia without mechanical or motor causes were identified and divided into three groups based on whether dysphagia was their primary, secondary or tertiary symptom. A control group consisted of randomly selected GERD patients with no dysphagia. The highest number of intraepithelial eosinophils per high-power field (HPF) in biopsies from the squamocolumnar junction (SCJ) and esophageal body was compared across groups.
  
  
  RESULTS
  There were 71 patients with unexplained dysphagia. Dysphagia was the primary symptom in 13 (18%), secondary symptom in 34 (48%), and tertiary symptom in 24 (34%) patients. The number of eosinophils differed between the four groups, with the highest number in those with dysphagia as the primary symptom (P = 0.0007). This relationship persisted whether biopsies were from the SCJ (P = 0.0057) or esophageal body (P = 0.0096).
  
  
  CONCLUSIONS
  An association exists between the number of intraepithelial eosinophils and dysphagia in GERD patients, with the highest number of eosinophils in those with the primary symptom of dysphagia.
authors: Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors: Shahin
authors: S
authors: Ayazi
authors: Jeffrey A
authors: JA
authors: Hagen
authors: Parakrama
authors: P
authors: Chandrasoma
authors: Parviz
authors: P
authors: Gholami
authors: Joerg
authors: J
authors: Zehetner
authors: Arzu
authors: A
authors: Oezcelik
authors: John C
authors: JC
authors: Lipham
authors: Steven R
authors: SR
authors: Demeester
authors: Tom R
authors: TR
authors: Demeester
authors: Michael M
authors: MM
authors: Kline
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003680:Deglutition Disorders / Q000473:pathology*; D004802:Eosinophilia / Q000473:pathology*; D004804:Eosinophils / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D004942:Esophagitis, Peptic / Q000473:pathology*; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000473:pathology*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012307:Risk Factors