Eosinophilic Esophagitis: What Information Can We Get from the Subepithelium?

Correlations between subepithelial EoE activity and endoscopic and symptom severity are noted, but clinical implications are yet unclear.

By consensus agreement, eosinophilic esophagitis (EoE) is characterized histologically (after an 8-week trial of proton-pump inhibitor therapy) by persistent mucosal eosinophil (eos) counts ≥15/high-power field (hpf). Little has been reported however, about subepithelial involvement in EoE.

In a prospective analysis from an EoE-specialized clinic in Switzerland, researchers evaluated both the epithelial and subepithelial layers of eosinophilic esophageal inflammation in 200 adult patients with established EoE undergoing esophagogastroduodenoscopy. A single endoscopist performing all procedures used a technique of tangential positioning of closed forceps and then suction before biopsy to optimize deep tissue procurement.

Peak epithelial eosino…

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