[Eosinophilic esophagitis]

Abstract

Eosinophilic esophagitis (EE) is characterized by eosinophilic infiltration of the esophageal wall including mucosa, submucosa, and muscle proper. EE is a condition involving both pediatrics and adults. Patients with EE are predominantly young males, commonly related to atopy. The typical clinical presentation includes dysphasia, food impaction, and symptoms mimicking gastroesophageal reflux disease. Endoscopic examination reveals mucosal fragility, ring or corrugated mucosa, whitish plaques, or small caliber esophagus. Histologic finding of >20 eosinophils/HPF (high power field) is the diagnostic hallmark of EE. Elemental formula, systemic or topical corticosteroid, anti-inflammatory drugs such as leukotriene receptor antagonists, anti-interleukin (IL)-5, and anti-IL-13 monoclonal antibodies have been used to manage EE. Esophageal dilation is considered in adult patients with severe obstructive symptoms due to stricture.