How Many Biopsies Are Best in Diagnosing EoE?

Take at least four biopsies, but no more than six, from the mid or proximal esophagus or both.

The recent national guideline for diagnosis of eosinophilic esophagitis (EoE) recommends that clinicians exclude a diagnosis of proton-pump inhibitor–responsive esophageal eosinophilia (PPI-REE) — a newly recognized entity — by administering a 2-month course of a PPI, followed by endoscopy with two to four biopsies from both the proximal and distal esophagus (NEJM JW Gastroenterol June 7 2013).

To assess the potential for diagnosis of EoE without a PPI trial, researchers evaluated biopsy samples of 102 PPI-naive patients diagnosed with EoE to determine the optimal number of biopsies to take, and in what locations, to meet the minimum morphologic diagnosis criteria of EoE (≥15 eosinophils per high-power field). Biopsies had been taken from th…

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