Eosinophilic esophagitis

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Figure 1
- Endoscopy images revealing characteristic signs in patients with eosinophilic esophagitis. A) Mild trachealization (concentric mucosal rings) and narrowing of the esophageal lumen. B) Furrows, C) whitish exudates, D) whitish exudates with furrows, E) eosinophilic abscess, F) stricture
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Figure 2
- Stepwise approach to diagnosis of EoE. ^aExample target ≥3 samples from upper esophagus and ≥3 samples from lower esophagus. ^bTraditional hpf using optical microscopy is equivalent to 0.3 mm² using digital microscopy.
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Figure 3
- Biopsy samples obtained from proximal esophagus of a 44-year-old male patient who was diagnosed with active EoE (marked eosinophilia [>40/hpf] associated with degranulation and basal epithelial hyperplasia; A: original magnification, x400; B: x600) and subsequently achieved complete remission following treatment (no evident pathology; C: original magnification, x100; D: x200). He was prescribed omeprazole 40 mg bid plus swallowed topical steriods (fluticasone [Flixotide] 125 μg four puffs twice daily) for 8 weeks with no adverse effects.

Table 1

- Clinical features of eosinophilic esophagitis.

Features	Adult	Pediatric
Common	Dysphagia Food impaction/foreign body Esophageal stricture Nausea/vomiting Heartburn Food allergy	Abdominal pain Failure to thrive Dysphagia
Uncommon	Hematemesis Globus Weight loss	Food impaction
Associated conditions	History of atopy Asthma Allergic rhinitis	Asthma Allergic rhinitis Eczema Atopic dermatitis Family history of atopy`