Eosinophilic Esophagitis
Clinical
- Peak age 20-40 years
- Range 6 months to 89 years
- Rare under 1 year of age
- Frequently associated with allergy, asthma, atopy
- Peripheral eosinophilia may be present but usually <1500/ml
- May have dysphagia, focal strictures and food impaction
- Endoscopic findings
- Longitudinal furrows
- Multiple rings (feline esophagus)
- Fragile and inelastic (crepe paper esophagus)
- White exudates
- Focal strictures and long segment strictures
- Failure to thrive in infants
- Pediatric
- May respond to elemental (amino acid) diet or dietary restrictions
- May respond partially or not at all to anti-reflux therapy
- May respond to oral steroids
- Adult
- Increasingly diagnosed in patients refractory to anti-reflux therapy with normal pH
- May respond to antihistamines or topical steroids
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