TITLE:
Eosinophilic esophagitis in Egyptian adult patients presenting with upper gastrointestinal symptoms
AUTHORS:
Shereen Shoukry Hunter, Dina Omar Helmy, Naglaa Aly Zayed, Tamer Mohamed El-Tayeb, Magdy Amin El-Serafy
KEYWORDS:
Eosinophilic Esophagitis (EoE); Adults; Gastroesophageal Reflux Disease (GERD); Egypt
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.4 No.2,
February
25,
2014
ABSTRACT: Background and Study Aim: Eosinophilic
esophagitis (EoE) is a clinicopathological disease characterized by
esophageal dysfunction and marked esophageal eosinophilic infiltration. It
shows a marked increase in incidence and prevalence and has been associated
with gastroesophageal reflux disease (GERD). The aim of this work was to detect
the prevalence of EoE in Egyptian adult patients presenting with upper
gastrointestinal symptoms and to clarify its clinical pattern and the
possibility of its overlap with GERD. Patients and Methods: The study included
91 adult patients presenting with various upper gastrointestinal symptoms.
Upper gastrointestinal endoscopy was done and esophageal biopsies were taken.
The presence of >15 eosinophils per high power field together with a history
of intake of proton pump inhibitors for at least 3 weeks without improvement was
used as prerequisite diagnostic criteria for EoE. Results: Classification of
the patients was based on both endoscopic and histo-pathological findings.
Accordingly, out of the 91 patients, 70 had GERD (76.9%); 58 of them had
erosive reflux disease (ERD) and 12 had endoscopically normal esophagus but
with histopathological changes compatible with reflux esophagitis and were
classified as non erosive reflux disease (NERD). Eighteen patients had normal
endoscopic and histopathological esophagus (19.8%), and 3 patients had EoE
(3.3%), with an overlap between ERD and EoE in one patient. The mean age of EoE
patients was 41.6 ± 11.7 years. Two of them were males and one was a female.
All of the 3 patients complained of
dysphagia and none complained of heartburn. The endoscopists did not
report any endoscopic findings characteristic of EoE. Conclusion: The
prevalence of EoE is low in adult Egyptian patients presenting with upper
gastrointestinal symptoms. Dysphagia is the main presenting symptom of EoE
while heartburn is not characteristic of the disease. Normal esophagus
endoscopically does not exclude EoE.