What is the prognosis of eosinophilic esophagitis (EoE)?

Answer

Eosinophilic esophagitis (EoE) is a chronic, antigen-driven inflammatory disease with an allergenic nature of antigen. Current therapies include dietary therapy, topical steroids, and proton pump inhibitors,^{[59, 60, 61]} as well as endoscopic dilation in cases with strictures.^{[61, 62]}The disease has been seen to remit with treatment such as dietary exclusions of antigenic foods and/or topical steroids.^{[3, 63, 64]}

More recently, investigational therapies include "novel, esophageal-targeted formulas of topic corticosteroids, and monoclonal antibodies (including mepolizumab, reslizumab, QAX576, RPC4046, dupilumab, omalizumab, infliximab and vedolizumab)."^[61]

Since EoE is a recently recognized entity, the natural history of EoE and predictive factors of complications are yet unknown.^[2]

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Media Gallery

Eosinophilic esophagitis. Increased eosinophils in squamous mucosa, more than 15 per high power field (hpf).
Eosinophilic esophagitis. Superficial layering of eosinophils with desquamation.
Eosinophilic esophagitis. Eosinophilic microabscesses.
Eosinophilic esophagitis. Eosinophil degranulation.
Eosinophilic esophagitis. Architectural abnormalities (basal cell hyperplasia and elongation of vascular papillae).
Eosinophilic esophagitis. Normal esophagus.
Eosinophilic esophagitis. Reflux esophagitis.
Eosinophilic esophagitis. Endoscopic appearance of a patient with eosinophilic esophagitis. Mucosal edema (loss of vascular markings), longitudinal furrows, and exudates are present. Courtesy of Jordan Shapiro, MD.
Eosinophilic esophagitis. Endoscopic appearance of a patient with eosinophilic esophagitis. Mucosal edema (loss of vascular markings), exudates, longitudinal furrows, and rings (sometimes referred to as trachealization of the esophagus) are present. Courtesy of Jordan Shapiro, MD.
Eosinophilic esophagitis. Subepithelial fibrosis and infiltration with eosinophils showing degranulation.

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Author

Nina Tatevian, MD, PhD, FCAP Associate Professor, Director, Pediatric/Perinatal Pathology Division, Department of Pathology and Laboratory Medicine, University of Texas Medical School at Houston; Adjunct Associate Professor, Department of Pathology, Baylor College of Medicine

Nina Tatevian, MD, PhD, FCAP is a member of the following medical societies: American Society for Clinical Pathology, Association of Clinical Scientists, College of American Pathologists, Society for Pediatric Pathology

Disclosure: Nothing to disclose.

Coauthor(s)

Sadhna Dhingra, MD, FCAP Associate Professor, Department of Pathology and Immunology and Medicine, Section Head of Adult GI/Liver Pathology, Baylor College of Medicine; GI/Liver and Renal Pathologist, Director of Resident Rotation in Anatomic Pathology, Baylor St Luke's Medical Center

Sadhna Dhingra, MD, FCAP is a member of the following medical societies: Association of Clinical Scientists, College of American Pathologists, Hans Popper Hepatopathology Society, Texas Society of Pathologists, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Chief Editor

Nirag C Jhala, MD, MBBS Director of Anatomic Pathology, Director of Cytopathology, Temple University Hospital; Professor of Pathology and Laboratory Medicine, Temple University School of Medicine

Nirag C Jhala, MD, MBBS is a member of the following medical societies: American Society of Cytopathology, Biomedical Engineering Society, College of American Pathologists, International Academy of Cytology, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Additional Contributors

Mamoun Younes, MD Professor of Pathology, Director of Gastrointestinal and Liver Pathology Service, University of Texas Health Science Center at Houston, McGovern Medical School

Mamoun Younes, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society of Clinical Oncology, College of American Pathologists, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Melissa P Upton, MD Associate Professor of Pathology, University of Washington School of Medicine; Associate Director, Anatomic Pathology Division, Director, Rodger C Haggitt Gastroenterologic and Hepatic Pathology Service, University of Washington Medical Center

Melissa P Upton, MD is a member of the following medical societies: American Society for Investigative Pathology, American Society for Clinical Pathology, College of American Pathologists, United States and Canadian Academy of Pathology, Transplantation Society, Hans Popper Hepatopathology Society, World Organization for Specialized Studies on Diseases of the Esophagus, Pacific Northwest Society of Pathologists

Disclosure: Nothing to disclose.

What is the prognosis of eosinophilic esophagitis (EoE)?

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