Eosinophilic esophagitis: an allergist's approach.

OBJECTIVE

To enhance the recognition of eosinophilic esophagitis by reviewing the presentation, diagnosis, and pathogenesis and then summarizing the epidemiology and treatment options.

METHODS

MEDLINE was searched for articles using the keywords esophagitis and either allergy or eosinophil. Additional sources include searches limited to therapy, including corticosteroids and leukotrienes, and those limited to review articles, including chemokines and cytokines, from January 1990 to April 2006. All searches were limited to the English language.

METHODS

The authors selected relevant and current sources for inclusion in this review.

RESULTS

Eosinophilic esophagitis is a diagnosis made by identifying 20 to 24 eosinophils per high-power field on examination of esophageal biopsy specimens. In recent years, a marked increase in incidence worldwide may have occurred. Although the pathogenesis is still unclear, therapy involves the use of corticosteroids and appropriate dietary elimination.

CONCLUSIONS

Patients with atopy, especially males, who present with dysphagia, reflux symptoms, vomiting, abdominal pain, or failure to thrive should be considered for endoscopy to establish the diagnosis of eosinophilic esophagitis.