Eosinophilic esophagitis
Summary
EoE is a chronic immune-mediated inflammatory disorder with eosinophil infiltration (>15/HPF) of the esophageal mucosa, presenting with dysphagia to solids and food impaction. Driven by Th2-mediated allergic inflammation.
Detail
Pathophysiology involves Th2 cell-driven inflammation with IL-5, IL-13 promoting eosinophil recruitment via eotaxin-3. Eosinophils degranulate, causing mucosal damage and fibrosis. Endoscopic findings: rings (trachealization), furrows, white plaques. Diagnosis requires biopsies from multiple levels showing >15 eos/HPF. Treatment: allergen avoidance (milk most common trigger), PPI therapy, topical corticosteroids (swallowed fluticasone/budesonide), biologics for refractory cases.
Sources
- First Aid for the USMLE Step 1
- Robbins Basic Pathology
- Harrison's Principles of Internal Medicine
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