The diagnosis of eosinophilic esophagitis (EoE) is based on consensus reccommendations published in 2007. Nevertheless non uniformity in diagnostic defintion and non adherence to consensus recomendations continue to be observed even in recent publications.It leads to a definition problem of EoE since it is known that esophageal eosinophilia may be caused also by GERD,PP- responsive EE and extraesophageal systemic diseases. What is your stratgy for assuring a diagnosis of EoE in suspected patients?
The symptoms are very disturbios and prominent suche as food imparctions episodios but the most remarkable findind is to hace moré than 15 eosinophils by H P F in the esophageal biopsies
Dear Luis Rodrigo
More than 15 eosinophils/HPF in esoopageal mucosa defines esophageal eosinophilia (EE). Only 30 to 50% of patiens with EE realy have EoE. To identify EoE it is recommnded to give a PPI trial to patients or to rule out GERD or PPI respondant -EE (PPI-REE) properly. I would lke to know you opinion at this regard
Best regards.
I agree at all with your new sugestión of curse. Thank you for your coment
The diagnosis of EoE is typically made on the combination of symptoms and findings on diagnostic testing. OGDS with biopsy, with a minimum of 15 eosinophils per high-power field are required to make the diagnosis. Endoscopically, ridges, furrows, or rings may be seen in the esophageal wall.
With the development of the EE Diagnostic Panel, we seldom use the PPI trial to diagnose EoE. I would recommend OGDS with biopsy in those patients with swallowing difficulty, food impaction, and heartburn.
Dear Chieng jin yu
What EE Diagnostic panel are you talking about?.
PPI trial is very usefull for ruling out GERD and PPI-responsive EE. Currently there is no biological nor image marker for diagnosis of EoE. Response to PPI tral is one of the components of diagnostic definition of EoE according to consensus recommendations.
Dear Dr Diego,
I mean the EoE diagnostic panel as Esophageal Peak Eosinophil Count - suggest to refer
Furuta et al. Gastroenterology. 2007
Liacouras et al. J Allergy Clin Immunol. 2011
Anyone has idea about the molecular diagnostic - Eosinophilic Esophagitis Diagnostic Panel (EDP) ?
Dear Chen ji yu
Thank you for your response.
The references you have given are the consensus recommendations that have defined EoE as an immune chronic disease that has to be diagnosed with presence of esophageal symptoms, ≥15 eosinophils /HPF in esophageal mucosa and non-response to PPI trial, particularly the last two components.
Currently this is the gold standard for diagnosis of EoE.
Efficcious biological/molecuar markers are not existant.
Best regards.
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