A recent study shows similar clinical, endoscopic and histologic findings between eosinophilic esophagitis (EoE) and proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE) (Aliment Pharmacol There 2014; 39: 603-08 -thanks to Seth Marcus for this reference).
The authors used two databases: one from Walter Reed and one from the Swiss EoE database. All of these patients were >/=18 years. Response to PPI was defined as achieving less than 15 eos/hpf and a 50% decrease from baseline following at least 6-weeks of PPI treatment.
Demographics: 63 EoE patients, 40 PPI-REE, mean age 40 years (75% male, 89% Caucasian).
- Similar dysphagia 97% vs. 100% (in EoE and of PPI-REE cohorts)
- Similar food impaction 43% vs. 35% (in EoE and of PPI-REE cohorts)
- Similar heartburn 33% vs. 32% (in EoE and of PPI-REE cohorts)
- Similar duration of symptoms: 6.0 years vs 5.8 years (in EoE and of PPI-REE cohorts)
- Similar endoscopic findings too: rings 68% in both groups, furrows 70% in both groups, strictures 49% vs 30% (in EoE and of PPI-REE cohorts)
- Similar histology: proximal esophagus 39 vs 38 eos/hpf and distal esophagus 50 vs 43 eos/hpf
Take-home message: EoE and PPI-REE are very similar in presentation and indistinguishable without a PPI trial.
Related blog posts:
- Nexium versus Fluticasone for EoE | gutsandgrowth
- EoE -Journal Club (Part 1) | gutsandgrowth
- EoE: Drugs, Diets, Dilatation and PPI-REE | gutsandgrowth