Differential Diagnosis: EoE vs. PPI-Responsive Esophageal Eosinophilia

Response to an 8-week course of proton-pump inhibitors remains the only reliable way to distinguish between these two conditions.

Eosinophilic esophagitis (EoE) is recognized by characteristic endoscopic features and histologic evidence of esophageal eosinophilia (≥15 eosinophils per high-power field). However, recognition is growing that more than one third of all patients with endoscopic features suggestive of EoE and esophageal eosinophilia on biopsy will respond to a proton-pump inhibitor (PPI). As suggested in national guidelines, before diagnosing EoE in these patients, clinicians should rule out PPI-responsive esophageal eosinophilia (REE; NEJM JW Gastroenterol Jun 7 2013).

To determine the prevalences and distinguishing characteristics (histologic, endoscopic, or clinical) of PPI-REE and EoE, investigators conducted a prospective cohort study of patients underg…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors