HISTOLOGICAL FEATURES OF EOSINOPHILIC ESOPHAGITIS IN CHILDREN AND ADOLESCENTS

HISTOLOGICAL FEATURES OF EOSINOPHILIC ESOPHAGITIS IN CHILDREN AND ADOLESCENTS

Eosinophilic esophagitis is an emerging disease featured by eosinophilic esophageal infiltrate not responsive to proton pump inhibitors. To characterize histological features of children and adolescents with eosinophilic esophagitis. Cross-sectional study in a tertiary hospital. Biopsies from each e...

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Bibliographic Details
Published in:Arquivos de gastroenterologia Vol. 54; no. 4; pp. 281 - 285
Main Authors: Carrasco, Adriana Elisabeth Aguiar Benavides, Machado, Rodrigo Strehl, Patrício, Francy Reis da Silva, Kawakami, Elisabete
Format: Journal Article
Language:English
Published: Brazil Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE 01-12-2017
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)
Subjects:
Adolescent
Biopsy
Child
Child, Preschool
Cross-Sectional Studies
Doenças do esôfago
Dor abdominal
Eosinophilic Esophagitis - pathology
Eosinófilos
Esofagite eosinofílica
Esofagite péptica
Esophagus - pathology
Female
GASTROENTEROLOGY & HEPATOLOGY
Humans
Infant
Male
Prospective Studies
Esophageal diseases
Eosinófilos
Esofagite péptica
Peptic esophagitis
Esofagite eosinofílica
Eosinophilic esophagitis
Doenças do esôfago
Abdominal pain
Dor abdominal
Eosinophils
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Description
Summary:Eosinophilic esophagitis is an emerging disease featured by eosinophilic esophageal infiltrate not responsive to proton pump inhibitors. To characterize histological features of children and adolescents with eosinophilic esophagitis. Cross-sectional study in a tertiary hospital. Biopsies from each esophageal third from 14 patients (median age 7 years) with eosinophilic esophagitis were evaluated. Histological features evaluated included morphometry of esophageal epithelium, esophageal density (per high power field), extracellular eosinophilic granules, eosinophilic microabscesses, surface disposition of eosinophils, epithelial desquamation, peripapillary eosinophilia, basal layer hyperplasia and papillary elongation. Several patients presented a normal esophageal macroscopy in the upper digestive endoscopy (6, 42.8%), and the most common abnormality were vertical lines (7, 50%) and whitish spots over esophageal mucosa (7, 50%). Basal layer hyperplasia was observed in 88.8%, 100% e 80% of biopsies from proximal, middle and lower esophagus, respectively (P=0.22). Esophageal density ranges from 0 to more than 50 per hpf. Extracellular eosinophilic granules (70%-100%), surface disposition of eosinophils (60%-93%), epithelial desquamation (60%-100%), peripapillary eosinophilia (70%-80%) were common, but evenly distributed among each esophageal third. Just one patient did not present eosinophils in the lower third, four in the middle third and four in the upper esophageal third. In the absence of hypereosinophilia, other histological features are present in eosinophilic esophagitis and may contribute to diagnosis. Eosinophilic infiltrate is focal, therefore multiple biopsies are needed for diagnosis.
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ISSN:0004-2803
1678-4219
1678-4219
DOI:10.1590/s0004-2803.201700000-44