Title: Unraveling Esophageal Eosinophilia in Veteran Population
Abstract: Purpose: Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of esophagus affecting children and adults and requires 15 eosinophils/hpf for pathological confirmation. Clinical and endoscopic features of esophageal eosinophilia among elderly veterans and the implications of lower esophageal eosinophilia (<15 cells/hpf) are largely unknown. Our aim was to study the prevalence of EoE among veterans with food impaction and non-obstructive dysphagia and to compare the clinical and endoscopic features of esophageal eosinophilia with and without EoE. Methods: All the patients with esophageal eosinophilia during 2005 to 2011 were abstracted from the pathology database of a tertiary care VA hospital. These patients were categorized as EoE, if they had ≥15 eosinophils/hpf of the esophagus and esophageal eosinophilia group if they had <15 eosinophils/hpf. All the patients undergoing upper endoscopy were queried for food impaction and non-obstructive dysphagia from the endoscopy database during the same period to identify the prevalence of EoE. Patients with other causes of esophagitis (pill induced, radiation, post ablation and acid reflux with classic LA grades of esophagitis) were excluded. Fischer's Exact and Mann-Whitney tests were used for categorical and continuous variables, respectively. Results: The mean eosinophil density in the EoE (n=26) and the esophageal eosinophilia (n=22) groups were 28.6±22 and 8.6±4.0, p=0.001 respectively. The prevalence of EoE was 8% in patients with food impaction (n=75) and 1.1% in those with non-obstructive dysphagia (n=1708). The prevalence of esophageal eosinophilia (excluding EoE) was 2.6% in patients with food impaction and 1.1% in those with non-obstructive dysphagia. Patients with EoE and esophageal eosinophilia had similar demographics-mean age (53.5 vs 60.5%, p=0.5), gender (81% vs 90.9%, p=0.6) and Caucasian race (69.3% vs 68.2%, p=1.0) and also had similar prevalence of food impaction (23% vs 9.1%, p=0.3), history of allergies (19.1% vs 22.7%, p=1.0), peripheral eosinophilia (26.9% vs 18.1%, p=0.5) and rings (46% vs 54%, p=NS). Conclusion: Compared to the published literature, EoE appears to be less prevalent in veterans with food impaction and non-obstructive dysphagia. Important clinical and endoscopic features were similar between patients with EoE and esophageal eosinophilia without EoE. This subgroup of patients with esophageal eosinophilia that is milder than EoE may have similar clinical pattern and needs to be further studied.Figure 1: No Caption available.
Publication Year: 2012
Publication Date: 2012-10-01
Language: en
Type: article
Indexed In: ['crossref']
Access and Citation
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot