Eosinophilic Oesophagitis and Proton Pump Inhibitor-Responsive Oesophageal Eosinophilia Have Similar Clinical, Endoscopic and Histological Findings

F. J. Moawad; A. M. Schoepfer; E. Safroneeva‡, M. R. Ally; Y.-J. Chen; C. L. Maydonovitch; R. K. H. Wong

Disclosures

Aliment Pharmacol Ther. 2014;39(6):603-608. 

In This Article

Methods

Study Design

Two separate databases were reviewed from 2011 to 2012, which included patients from Walter Reed National Military Medical Center and the Swiss EoE database (SEED). Review was limited to after 2011 to include only patients diagnosed per latest EoE consensus statement. Data from the two institutions, who share similar methods in monitoring EoE patients with established registries, were combined to increase the total sample size of the study. All adult patients (≥18 years of age) were consecutively enrolled in their respective registries. Patients were stratified into two groups: EoE and PPI-REE. EoE was defined by the most recent consensus guidelines: clinically by symptoms of oesophageal dysfunction, histologically by the presence of at least 15 eos/hpf on oesophageal biopsies and a lack of response to a course of PPI treatment.[2] PPI-REE was defined as presenting with similar clinical symptoms as EoE yet achieving less than 15 eosinophils eos/hpf and a 50% decrease from baseline following at least a 6-week course of twice-daily PPI treatment.

Data Collection

For each patient, data on demographics (race, age, gender), clinical presentation (dysphagia, food impaction, heartburn), duration of symptoms, endoscopic features (rings, furrows, plaques, strictures, Schatzki's rings, presence of erosive oesophagitis) and whether dilation had been performed were collected. If available, results of a 24-h pH study were also recorded. GERD was defined when % total time pH <4 was greater than 4.2% time of the study period. Coexisting atopy and allergy history (allergic rhinitis, asthma, food allergies, and seasonal allergies) and histological features (peak proximal and peak distal eosinophils count) were also obtained from the databases and electronic medical records.

Statistical Analysis

Data were collated and analysed using statistical software spss version 16 (Statistical Package for the Social Sciences, Chicago, IL, USA). Data for categorical variables are expressed as proportions and percentages and data for continuous variables are expressed as means and standard deviations. Between-group comparisons of demographic, clinical and endoscopic variables were analysed with Fisher's exact test for categorical variables, and student's independent t-test for continuous variables. A P-value of less than 0.05 was considered statistically significant.

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