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  • Title: Eosinophilic oesophagitis in patients presenting with dysphagia--a prospective analysis.
    Author: Mackenzie SH, Go M, Chadwick B, Thomas K, Fang J, Kuwada S, Lamphier S, Hilden K, Peterson K.
    Journal: Aliment Pharmacol Ther; 2008 Nov 01; 28(9):1140-6. PubMed ID: 18624788.
    Abstract:
    BACKGROUND: Eosinophilic oesophagitis (EoO) may be a common finding in adults presenting with dysphagia. AIM: To identify the risk factors and prevalence of EoO in an adult population with dysphagia. METHODS: All patients with dysphagia referred for an upper endoscopy (EGD) were asked to participate. Patients completed a detailed questionnaire followed by EGD with four quadrant biopsies in the distal and mid-oesophagus. Primary endpoint was the prevalence of EoO; secondary endpoints included age, gender, asthma, food allergies, gastro-oesophageal reflux disease/dysphagia score and endoscopic findings. RESULTS: Two hundred and sixty-one patients enrolled between December 2005 and January 2007. Thirty-one patients (12%) met pathological criteria for EoO. There was no difference in EoO prevalence within each gender. Mean age of EoO patients was 42 +/- 15 vs. 61 +/- 15 for non-EoO patients (P < 0.001). EoO was diagnosed in 35% of patients <50 years of age. EoO was present in 22% of asthmatics vs. 9% non-asthmatics (P < 0.01). EoO was present in 36.8% of patients with self-reported food allergies vs. 9.3% those without allergy (P < 0.001). A 13/31(42%) of EoO patients did not have the classic EGD findings (rings +/- furrows) and would have been missed without oesophageal biopsies. CONCLUSIONS: Eosinophilic oesophagitis was diagnosed in 12% of the patients presenting with dysphagia with relative risk of 9.5 if age <50 years. Oesophageal biopsies are warranted in patients presenting with dysphagia especially in the younger population. Patients may not present with classic endoscopic findings and EoO can be missed without biopsies.
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