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New Research - July 2009Diagnostic criteria for eosinophilc esophagitisThe objective of this study was to determine whether eosinophilic esophagitis has been unrecognized based upon the observation that the diagnosis based solely on the number of eosinophils per high powered field does not, in the estimation of the authors, appear to capture all patients with eosinophilic esophagitis. The investigators decided to look at clinical features that might predict the presence of eosinophilic esophagitis (EE) and also assess the efficacy of the Luna eosinophil granule stain (LEG) to detect of the presence of eosinophils.They performed esophageal biopsies in 202 children younger than 18 years of age. The study was done between 2000 and 2004. Chart extraction was used to assess clinical variables. The LEG stain for 60 random selected patients was prepared and compared to the H and E stain. They found that the clinically significant variables predicting EE were the following:
The LEG stain appeared to be superior to H and E in detection of low eosinophils per high powered field (mean 24.82 and 38.53 respectively). They concluded that misdiagnosed cases of EE decreased, but prevalence appeared to increase. They felt that the LEG was potentially a better stain than H and E. They also concluded the key clinical values were typical endoscopic findings as noted above, and improvement with treatment for EE. Reference
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