ASGE Recognized Industry Associate (ARIA) Training Program for Regeneron | June 2022-Epidemiology and Diagnosis of EoE

Pdf Summary

Eosinophilic Esophagitis (EoE) is a chronic immune-mediated disease that is driven by food allergens. It is characterized by symptoms related to esophageal dysfunction and the presence of eosinophil-predominant inflammation in the esophagus. A minimum threshold of 15 eosinophils per high power field (hpf) is required for the diagnosis of EoE. The condition is isolated to the esophagus and other causes of eosinophilia must be ruled out.<br /><br />EoE has a prevalence of approximately 34 cases per 100,000 individuals, making it relatively uncommon compared to conditions such as asthma and seasonal allergies. It is more common in males, and about 78% of patients with EoE also have at least one other atopic disease.<br /><br />Early life factors, such as antibiotic use, cesarean section, and preterm delivery, have been associated with an increased risk of developing EoE in adulthood. The condition is often diagnosed in adults in their 30s or 40s and is frequently accompanied by a history of atopy.<br /><br />Clinical presentation in adults includes symptoms such as dysphagia and food impaction. Endoscopic findings may include features such as edema, rings, exudates, furrows, and strictures. Histologic features of EoE include superficial layering, eosinophilic microabscesses, spongiosis, epithelial hyperplasia, degranulation, and lamina propria fibrosis.<br /><br />The natural history of EoE involves a progressive fibrotic process if left untreated, leading to complications such as strictures. Diagnostic delay has been shown to increase the risk of developing fibrotic features. Therefore, early diagnosis and treatment are important to prevent long-term complications.<br /><br />In summary, Eosinophilic Esophagitis is a chronic immune-mediated disease characterized by esophageal dysfunction and eosinophil-predominant inflammation. It is relatively uncommon compared to other atopic conditions, and early diagnosis and treatment are crucial to prevent complications associated with fibrosis.

Asset Subtitle

Walter Chan, MD, MPH

Keywords

Eosinophilic Esophagitis

EoE

immune-mediated disease

esophageal dysfunction

eosinophil-predominant inflammation

prevalence

atopic disease

fibrotic process

complications

early diagnosis