Could be possible to predict eosinophil accumulation in esophageal mucosa in eosinophilic esophagitis without perform endoscopic examination?

Eosinophilic esophagitis (EE) is a recently recognized but expanding disorder characterized by antigen-driven eosinophil accumulation in the esophagus, meanwhile all other segments of the gastrointestinal tract are normal. Patients typically have recurrent dysphagia and food impactions, and they have evidence of food and aeroallergen hypersensitivity. The esophagus is normally devoid of eosinophils (Eo), so the finding of esophageal eosinophilia denotes pathology. However, the mere presence of esophageal eosinophils is not specific for a particular disorder because eosinophil accumulation in the esophagus occurs in a variety of states; so, the diagnosis of EE requires elimination of other causes of esophagitis (1). Our work aims to evaluate the possible relationship between the serological levels Eo and IgE and the concentration of Eo on histology. We carried out a retrospective observational study analyzing nine adult patients diagnosed between January 2007 to May 2009 in the Hospital Alto Guadalquivir de Andújar (Jaén, Spain). EE was considered, the presence of more than 20 eosinophils per high power field x 400 (Eo CGA) and eosinophilia in the presence of more than 4% of blood Eo. We excluded the involvement of other sections of the digestive tract by taking biopsies of the stomach and duodenum. Informed consent was obtained from all patients to perform endoscopic examinations.