Prevelance of Eosinophilic Esophagitis in adult patients with dysphagia

Eosinophilic esophagitis is a chronic, immun-antigen mediated clinicopathologic disease characterized with symptoms of esophageal dysfunction and eosinophil predominant inflammation in esophageal mucosa. Recently, it has been suggested as a noteworthy underlying reason for dysphagia.In this study, we aimed to evaluate the prevelance of eosinophilic esophagitis in adult patients with dysphagia.In this retrospective study, clinical characteristics of 55 patients (age range 18-80 years) who had been investigated for dysphagia between June 2010 to June 2011 in Gastroenterology department of Gazi University were evaluated. All of patients had no major esophageal motor dysfunction on esophageal manometry and had esophageal biopsies taken from mid-proximal esophageus.We retrieved the demographic and clinic data of patients from the archives of the gastroenterology clinic and motility laboratory.All existing biopsies were reviewed by an experienced pathologist who blinded to the clinical and endoscopic data of the patients.We considered a cut-off number ? 15 eosinophils in at least one high power field (hpf,x400) as a diagnostic criteria for eosinophilic esophagitis. Gastric and duodenal biopsies were assessed to rule out the presence of eosinophilic gastroenteritis.There was histopathologic signs of eosinophilic esophagitis as eosinophilic microabscesses, eosinophilic degranulation, basal zone hyperplasia, lamina propria papillae elongation, necrotic epithelium in one patient and her maximal eosinophil count is 85/hpf. Altough this patient?s esophagial biopsy met the criteria of eosinophilic esophagitis, her gastric biopsy contained dense eosinophil infiltration (>150/hpf). Therefore this patient was diagnosed as eosinophilic gastritis.Non of 55 patients included in this study were found to have eosinophilic esophagitis. One patient (%1,8) had eosinophilic gastritis and 4 patients (%7,2) had esophageal eosinophilia. The diagnosis of these four patients was considered as reflux esophagitis by their symptoms and histopathologic signs.In conclusion, despite the number of patients in present study is relatively small for a prevelance determination study, it seems that, eosinophilic esophagitis is not a frequent reason for dysphagia in our country.Key words: Eosinophilic esophagitis, dysphagia, prevelance