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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
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Eosinophilic peak counts in eosinophilic esophagitis : a retrospective study
A Vanstapel1, T Vanuytsel2, G De Hertogh1
1Department of Pathology, University Hospitals Leuven, Belgium.
Acta Gastro-Enterologica Belgica
|July 18, 2019
Summary
Eosinophilic esophagitis (EoE) diagnosis relies on esophageal eosinophil counts. This study found pathologist experience doesn't impact diagnostic accuracy for EoE, suggesting other histologic features need investigation.
Area of Science:
- Gastroenterology
- Pathology
- Histology
Background:
- Histologic diagnosis of eosinophilic esophagitis (EoE) requires >15 eosinophils/high power field (HPF) in the esophagus.
- Controversy exists regarding the precise eosinophil count threshold for EoE diagnosis.
Purpose of the Study:
- Determine eosinophilic peak counts in esophageal, gastric, and duodenal biopsies from suspected EoE patients.
- Investigate correlations between eosinophilic peak counts across different biopsy locations.
- Assess inter-observer and intra-observer reliability in reporting eosinophilic peak counts.
Main Methods:
- Retrospective analysis of 103 suspected EoE patients undergoing endoscopy (June 2010 - July 2017).
- Eosinophilic peak counts per HPF were determined by a medical student and an experienced gastrointestinal pathologist.
Main Results:
- Highly variable eosinophilic peak counts observed: esophagus (median 110), stomach (median 3), duodenum (median 25).
- No significant correlation found between eosinophilic peak counts at different biopsy sites.
- Near-perfect inter-observer and intra-observer correlation (ρ 0.93-0.99) for reporting eosinophil counts.
Conclusions:
- Pathologist experience does not influence the accuracy of determining eosinophilic peak counts.
- Variability in reporting eosinophil counts is unlikely to affect EoE diagnostic accuracy.
- Further research into other histologic features is necessary to enhance EoE diagnostic accuracy.
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