Clinicopathological Differences between Eosinophilic Esophagitis and Asymptomatic Esophageal Eosinophilia

Objective According to consensus guidelines, eosinophilic esophagitis (EoE) is defined as a clinicopa-thological entity whose symptoms , histology must always be considered together. However, endoscopic findings typical of EoE are often seen in asymptomatic esophageal eosinophilia (aEE). We aimed to clarify the clinicopathological features of aEE. Methods We retrospectively compared cases of aEE and those of symptomatic EoE. Materials We reviewed 146 patients who underwent upper gastrointestinal endoscopy and were confirmed histopathologically to have esophageal eosinophil infiltration of at least 15 eosinophils per high-power field. They were divided into the aEE group (n=75) and the EoE group (n=71). Patients' clinicopathological find-ings were then collected and examined. Results The EoE group experienced dysphagia (47.9%), heartburn (40.8%), food impaction (40.8%), chest pain (16.9%) , other symptoms (8.5%). There was no significant difference between the two groups with regard to age, sex, current smoking status, or alcohol consumption. The aEE group had a significantly higher body mass index (p<0.01) and significantly lower frequency of concurrent allergic diseases (p<0.01) than the EoE group. No significant differences were found between the two groups with regard to the mean peripheral blood eosinophil count, non-specific immunoglobulin E concentration, peak eosinophil infiltration in the bi-opsy specimens, EoE histology scoring system, phenotype and location of typical endoscopic findings of EoE, or thickness of the esophagus wall or the mucosal and submucosal layer as measured by endoscopic ul-trasonography. Two patients in the aEE group who were followed up without treatment subsequently devel-oped esophageal symptoms. Conclusion aEE and EoE may have the same clinicopathological features.

Automated summary

This study compared the clinicopathological features of asymptomatic esophageal eosinophilia (aEE) and symptomatic eosinophilic esophagitis (EoE). The results showed that there were no significant differences between the two groups in many aspects, suggesting that aEE and EoE may have similar characteristics.