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Comprehensive Comparison of Dysphagia Predominant Eosinophilic Esophagitis: With and Without Food Impaction

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Abstract

We describe 101 EoE patients with dysphagia, with food impaction (EoE-FI) and without food impaction (EoE-NoFI). Compare clinical features, endoscopy, histology and 10 additional histological features (AHF), and outcomes. Clinical features, dysphagia score, and endoscopic findings were captured. Eosinophils and 10 AHF at diagnosis and follow-up were done. Two hundred seven patients were seen with EoE, 101 patients with dysphagia enrolled; Follow period was; EoE-FI, and 71 EoE-NoFI and mean ages of 10.9 and 10.4 years, respectively (p = 0.27). Clinical features, EGD, and biopsies were almost similar in both groups. EoE-FI, 1.7 years (mean), range 1/12–8 years, and EoE-NoFI, 1.1 years (1/12–7 years). Dysphagia score improved from 3 to 1.25 in EoE-FI and 1.21 to 0.71 in EoE-NoFI (p < 0.001). Composite score improved from 3.3 to 1.45 and 2.49 to 1.48 (p < 0.001) in EoE-FI and EoE-NoFI; 15/30 (EoE-FI) and 45/71(EoE-NoFI) patients had repeat EGD. Peak eosinophils in EoE-FI improved from 60 to 27 (p = 0.03), and in EoE-NoFI from 47.6 to 33 (p = 0.001). Mean eosinophils in EoE-FI improved from 42 to 27.5 (p = 0.03), and EoE-NoFI from 39.3 to 22.1(p < 0.001). Comparison of the 10 AHF at diagnosis and follow-up showed minimal numerical (%) differences, and none were significant. During follow-up, none had recurrence or occurrence of FI in both groups. There were no significant differences in the clinical features and outcomes of dysphagia in EoE-FI and EoE-NoFI groups. Endoscopy including strictures and histologic findings of eosinophils and the 10 AHF were similar in both groups at diagnosis and follow-up.

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Acknowledgements

The authors thank Henry Mangurten, MD, for the editorial revision of the manuscript.

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Authors and Affiliations

  1. Advocate Children’s Hospital, Loyola Medical Center and University of Illinois, 1775 Dempster Street, Park Ridge, IL, 60068, USA

    Thirumazhisai S. Gunasekaran & James Berman

  2. Advocate Children’s Hospital, 1775 Dempster Street, Park Ridge, IL, 60068, USA

    Vijayalakshmi Kory & Brian Adley

  3. University of Illinois at Chicago, Chicago, IL, USA

    Snehal S Sonawane, Mohamed Rizwan Haroon Al Rasheed & Alan Schwartz

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  1. Thirumazhisai S. Gunasekaran
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  2. Vijayalakshmi Kory
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  5. Brian Adley
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  6. Alan Schwartz
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Contributions

Thirumazhisai S. Gunasekaran, MD — study concept and design, drafting of the manuscript, final approval, and study supervision and administrative. Vijayalakshmi Kory, MBBS — data collection, analysis, and administrative. Snehal S. Sonawane, MBBS, MD — study design and interpretation of the histology. Mohamed Rizwan Haroon Al Rasheed, MBBS, MD — study design and interpretation of the histology. Brian Adley, MD — study design and supervision/interpretation of the histology. Alan Schwartz, PhD — statistical analysis and interpretation of data. James Berman, MD — critical revision of the manuscript for important intellectual.

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Correspondence to Thirumazhisai S. Gunasekaran.

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Institutional Review Board approval for this study was obtained through Advocate Health Care, Oak Brook, IL, USA.

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Gunasekaran, T.S., Kory, V., Sonawane, S.S. et al. Comprehensive Comparison of Dysphagia Predominant Eosinophilic Esophagitis: With and Without Food Impaction. SN Compr. Clin. Med. 3, 2134–2140 (2021). https://doi.org/10.1007/s42399-021-00889-1

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