Eosinophilic Esophagitis: Atopy Conditions of the Esophagus

Abstract

Eosinophilic esophagitis is an immune-allergic pathology of multifactorial etiology
(genetic and environmental) characterized by major symptoms of esophageal
dysphagia and eosinophil-predominant inflammation of the esophageal mucosa
that affects both pediatric and adult patients. EoE is an immune-mediated disease
by which environmental and food antigens stimulate the Th2 inflammatory
cascade. It is correlated with food allergy and atopy condition such as asthma, atopy
dermatitis, rhinitis allergic and often in conjunction with Gastroesophageal Reflux
Disease (GERD). Eosinophilic esophagitis (EoE) was first described in the 1990s,
showing an increasing incidence and prevalence since then, in the United States is
estimated to be approximately 57 per 100,000 persons being the leading cause of
food impaction and the major cause of dysphagia. Its symptoms, which include
heartburn, regurgitation, and esophageal stenosis. This symptomps similar to those
of gastroesophageal reflux disease, causing delays in diagnosis and treatment. The
endoscopic findings such as furrows, esophageal mucosa trachealization, and
whitish exudates, this diagnosis should be confirmed histologically confirmed by
biopsy on the presence of more than 15 eosinophils per high-power field and the
exclusion of other causes of eosinophilia. Management includes medications, diet,
and surgical dilatation.