title: Clinical symptom tool that raises the index of suspicion for eosinophilic oesophagitis in adults and drives earlier biopsy for definitive diagnosis.
abstract: Eosinophilic oesophagitis (EoE) and gastro-oesophageal reflux disease (GERD) present with overlapping symptomatology and it is challenging to distinguish EoE from GERD clinically before endoscopy.
  
  
  
  To investigate the prognostic value of a set of clinical symptoms and laboratory values in patients with EoE and GERD.
  
  
  
  In this prospective, single-centre, observational study, we compared clinical and laboratory data from 202 patients with EoE or GERD (10 relevant characteristics). Those characteristics showing potential significance in a univariate analysis were then included in a multivariate analysis.
  
  
  
  The set of 10 characteristics (10-marker set) was able to distinguish between EoE and GERD with good reliability (correct assignment, i.e. agreement with subsequent EGD, of 94.4%). Reduction of the set to the six statistically and clinically most relevant markers continued to give good reliability (88.9%), and further stepwise reduction led to four-marker sets comprising history of atopy, history of food impaction, proton pump inhibitor refractory symptoms and either immunoglobulin E or peripheral eosinophilia, with correct assignment rates of 91.3% and 85.1% respectively.
  
  
  
  We have developed a simple and easily applicable clinical/laboratory marker set that helps to distinguish EoE from GERD earlier in the treatment course, thus guiding the endoscopist to perform biopsies from the oesophagus to ensure the diagnosis. The application of the scoring system is expected to diagnose EoE earlier and avoiding delay of adequate treatment.
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: von Arnim
authors.affiliation: Institute of Biometrics and Medical Informatics, Otto von Guericke University, Magdeburg, Germany.
authors.forename: F-W
authors.initials: FW
authors.lastname: Röhl
authors.affiliation: Centre for Digestive Diseases, Hamburg- Eppendorf, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Miehlke
authors.affiliation: Institute of Pathology, Otto von Guericke University, Magdeburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Jechorek
authors.affiliation: Institute of Molecular and Clinical Immunology, Otto von Guericke University, Magdeburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Reinhold
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Wex
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Malfertheiner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D004724:Endoscopy; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D015203:Reproducibility of Results; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054328:Proton Pump Inhibitors