BACKGROUND: Eosinophilic esophagitis (EE) is now a commonly encountered disorder that was rarely diagnosed a decade ago. OBJECTIVE: We aimed to determine the epidemiologic and histologic features of retrospective pediatric esophageal eosinophilia before the first case of EE at our institution was recognized. METHODS: Esophageal biopsy specimens obtained between 1982 and 1999 with reflux esophagitis were re-examined and reorganized into 2 groups based on peak esophageal eosinophil number (<15 eosinophils per high-powered field [hpf] and > or =15 eosinophils/hpf). The epidemiology and histology of the entire cohort and a population-based cohort were evaluated. RESULTS: Eight hundred seven biopsy specimens from 666 patients were re-examined; 198 patients had 15 eosinophils/hpf or greater. Among a population-based cohort of patients with 15 eosinophils/hpf or greater, there was a modest increase in incidence (P < .001; incidence rate ratio, 1.18; 95% CI, 1.09-1.28). After correcting for a 40-fold increase in the number of endoscopies during this time period, the proportion of biopsy specimens with 15 eosinophils/hpf or greater did not change (0.08 in 1982 vs 0.08 in 1996 [peak]; P = .9; incidence rate ratio, 1.02; 95% CI, 0.73-1.44). Patients who had as few as 5 eosinophils/hpf were more likely to have persistent esophageal eosinophilia on repeat esophagogastroduodenoscopy, evidence of basal layer hyperplasia, and lamina propria fibrosis compared with patients with less than 5 eosinophils/hpf (P < .001). CONCLUSIONS: Esophageal eosinophilia at levels consistent with EE was present among 30% of patients given diagnoses of reflux esophagitis, and the incidence of esophageal eosinophilia did not change over time. Patients with 5 eosinophils/hpf or greater had evidence of other histologic abnormalities and were likely to have persistent esophageal eosinophilia. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
BACKGROUND:Eosinophilic esophagitis (EE) is now a commonly encountered disorder that was rarely diagnosed a decade ago. OBJECTIVE: We aimed to determine the epidemiologic and histologic features of retrospective pediatric esophageal eosinophilia before the first case of EE at our institution was recognized. METHODS: Esophageal biopsy specimens obtained between 1982 and 1999 with reflux esophagitis were re-examined and reorganized into 2 groups based on peak esophageal eosinophil number (<15 eosinophils per high-powered field [hpf] and > or =15 eosinophils/hpf). The epidemiology and histology of the entire cohort and a population-based cohort were evaluated. RESULTS: Eight hundred seven biopsy specimens from 666 patients were re-examined; 198 patients had 15 eosinophils/hpf or greater. Among a population-based cohort of patients with 15 eosinophils/hpf or greater, there was a modest increase in incidence (P < .001; incidence rate ratio, 1.18; 95% CI, 1.09-1.28). After correcting for a 40-fold increase in the number of endoscopies during this time period, the proportion of biopsy specimens with 15 eosinophils/hpf or greater did not change (0.08 in 1982 vs 0.08 in 1996 [peak]; P = .9; incidence rate ratio, 1.02; 95% CI, 0.73-1.44). Patients who had as few as 5 eosinophils/hpf were more likely to have persistent esophageal eosinophilia on repeat esophagogastroduodenoscopy, evidence of basal layer hyperplasia, and lamina propria fibrosis compared with patients with less than 5 eosinophils/hpf (P < .001). CONCLUSIONS:Esophageal eosinophilia at levels consistent with EE was present among 30% of patients given diagnoses of reflux esophagitis, and the incidence of esophageal eosinophilia did not change over time. Patients with 5 eosinophils/hpf or greater had evidence of other histologic abnormalities and were likely to have persistent esophageal eosinophilia. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
Authors: S R Orenstein; T M Shalaby; C Di Lorenzo; P E Putnam; L Sigurdsson; H Mousa; S A Kocoshis Journal: Am J Gastroenterol Date: 2000-06 Impact factor: 10.864
Authors: Jonathan M Spergel; Terri F Brown-Whitehorn; Janet L Beausoleil; James Franciosi; Michele Shuker; Ritu Verma; Chris A Liacouras Journal: J Pediatr Gastroenterol Nutr Date: 2009-01 Impact factor: 2.839
Authors: Richard J Noel; Philip E Putnam; Margaret H Collins; Amal H Assa'ad; Jesus R Guajardo; Sean C Jameson; Marc E Rothenberg Journal: Clin Gastroenterol Hepatol Date: 2004-07 Impact factor: 11.382
Authors: Cheryl Protheroe; Samantha A Woodruff; Giovanni de Petris; Vince Mukkada; Sergei I Ochkur; Sailajah Janarthanan; John C Lewis; Shabana Pasha; Tisha Lunsford; Lucinda Harris; Virender K Sharma; Michael P McGarry; Nancy A Lee; Glenn T Furuta; James J Lee Journal: Clin Gastroenterol Hepatol Date: 2009-04-01 Impact factor: 11.382
Authors: Charles W DeBrosse; James P Franciosi; Eileen C King; Bridget K Buckmeier Butz; Allison B Greenberg; Margaret H Collins; J Pablo Abonia; Amal Assa'ad; Philip E Putnam; Marc E Rothenberg Journal: J Allergy Clin Immunol Date: 2011-06-02 Impact factor: 10.793
Authors: Bruce S Bochner; Wendy Book; William W Busse; Joseph Butterfield; Glenn T Furuta; Gerald J Gleich; Amy D Klion; James J Lee; Kristin M Leiferman; Michael Minnicozzi; Redwan Moqbel; Marc E Rothenberg; Lawrence B Schwartz; Hans-Uwe Simon; Michael E Wechsler; Peter F Weller Journal: J Allergy Clin Immunol Date: 2012-09 Impact factor: 10.793
Authors: Evan S Dellon; Rune Erichsen; Lars Pedersen; Nicholas J Shaheen; John A Baron; Henrik T Sørensen; Mogens Vyberg Journal: World J Gastroenterol Date: 2013-01-28 Impact factor: 5.742