Eosinophilic Esophagitis

• •Young children: failure to thrive and food refusal;
• •Older children: vomiting, regurgitation, and epigastric and chest pain.
• •Adults: intermittent dysphagia, food impaction, heartburn;
• •Allergic symptoms (eczema, allergic rhinitis, and bronchospasm): 50% cases

• •25 eosinophils /HPF;
• •Eosinophilic microabscess (>4 eosinophils );
• •Profound eosinophilic degranulation;
• •Epithelial proliferation ( thickening of the basal epithelial layer; and elongation of the papillae);
• •Involve proximal and distal esophagus with normal gastric and duodenal mucosa;
• •All these patterns are resistant to PPI.

• •Resistant to proton pump inhibition;
• Dietary elimination;
• Topical steroids
• Endoscopic treatment

• •GI Motility online (May 2006)
• New England Journal of Medicine Volume 351:940-941
• Modern Pathology (2006) 19, 90–96.