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Diagnosis of Eosinophilic Esophagitis: Current Approach and Future Directions

Diagnosis of Eosinophilic Esophagitis: Current Approach and Future Directions Eosinophilic esophagitis (EoE), a chronic inflammatory condition with a rapidly evolving epidemiology, is now a major cause of esophageal disease. Current guidelines emphasize that EoE is a clinicopathologic condition with the following criteria: clinical symptoms of esophageal dysfunction; at least 15 eosinophils in one high-power field on esophageal biopsy; and lack of responsiveness to high-dose proton-pump inhibition or normal pH monitoring of the distal esophagus. Challenges in diagnosis include lack of standardized esophageal biopsy protocols, variability in how eosinophil counts are determined, variability in the size of microscope high-power fields, and the need to evaluate the differential diagnosis of esophageal eosinophilia. In particular, the complex interplay between esophageal eosinophilia, EoE, and reflux disease remains an area both of controversy and active study. In the future, diagnostic strategies could include symptom scores, tissue or noninvasive biomarkers, and/or genetic expression profiles. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Gastroenterology Reports Springer Journals

Diagnosis of Eosinophilic Esophagitis: Current Approach and Future Directions

Current Gastroenterology Reports , Volume 13 (3) – Mar 1, 2011

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References (59)

Publisher
Springer Journals
Copyright
Copyright © 2011 by Springer Science+Business Media, LLC
Subject
Medicine & Public Health; Gastroenterology
ISSN
1522-8037
eISSN
1534-312X
DOI
10.1007/s11894-011-0183-y
pmid
21360070
Publisher site
See Article on Publisher Site

Abstract

Eosinophilic esophagitis (EoE), a chronic inflammatory condition with a rapidly evolving epidemiology, is now a major cause of esophageal disease. Current guidelines emphasize that EoE is a clinicopathologic condition with the following criteria: clinical symptoms of esophageal dysfunction; at least 15 eosinophils in one high-power field on esophageal biopsy; and lack of responsiveness to high-dose proton-pump inhibition or normal pH monitoring of the distal esophagus. Challenges in diagnosis include lack of standardized esophageal biopsy protocols, variability in how eosinophil counts are determined, variability in the size of microscope high-power fields, and the need to evaluate the differential diagnosis of esophageal eosinophilia. In particular, the complex interplay between esophageal eosinophilia, EoE, and reflux disease remains an area both of controversy and active study. In the future, diagnostic strategies could include symptom scores, tissue or noninvasive biomarkers, and/or genetic expression profiles.

Journal

Current Gastroenterology ReportsSpringer Journals

Published: Mar 1, 2011

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