Abstract
Introduction: Last year we reported a previously unpublished endoscopic finding in children with eosinophilic/peptic esophagitis, viz VLEM (Gastrointest Endoscopy 1995;41:338). Aim: We now present data from a prospective study of this possible association and report on it's response to therapy. Methods: Endoscopists recorded the findings for each esophagogastroduodenoscopy (EGD) (n322) performed between 6/1/95-11/30/95 on a standard form. Histological assessments of esophageal mucosal biopsies were recorded. Results: VLEM were observed in 22 patients (pts) (ages 3mo-17 yrs) (12 new pts) who underwent 27 EGDs during the study period. Esophageal mucosal biopsies were obtained for histological study during each of these EGDs. VLEM were observed on 25 EGDs. 23/25 (92%; specificity 0.96, sensitivity 0.54) cases had eosinophilic esophagitis. 20/23 (87%) were subjectively graded moderate or severe by the pathologists. 14/22 pts underwent ≥1 EGDs. VLEM and histological findings were unchanged in 10/14 pts on follow up (f/u) (mean 6.7mo, range 2-19 mo) and improved/resolved in 3/14 on f/u (mean 12.3mo, range 5-27 mo). In one pt, VLEM appeared on repeat EGD (2 mo later) while the histology improved. All pts had received similar therapy (promotility agent and aggressive acid-suppression) and 11/14 reported symptomatic improvement. Conclusions: In this prospective study, we have confirmed our earlier retrospective observation of the positive correlation between VLEM and histological eosinophilic/peptic esophagitis. Additionally, the data suggests that VLEM and the associated histological abnormalities are generally slow to respond to therapy inspite of symptomatic improvement. Thus, prolonged therapy with endoscopie monitoring may be indicated. The long term implication(s) of these observations awaits further study.
| Original language | English |
|---|---|
| Pages (from-to) | 327 |
| Number of pages | 1 |
| Journal | Gastrointestinal Endoscopy |
| Volume | 43 |
| Issue number | 4 |
| State | Published - 1996 |
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ASJC Scopus subject areas
- Gastroenterology
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Longterm outcome of vertical lines in the (DISTAL) esophageal mucosa (VLEM) and eosinophilic esophagitis : A prospective study. / Gupta, Sandeep; Fitzgerald, J. F.; Chong, S. K F; Croffie, Joseph; Ellett, M. E.
In: Gastrointestinal Endoscopy, Vol. 43, No. 4, 1996, p. 327.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Longterm outcome of vertical lines in the (DISTAL) esophageal mucosa (VLEM) and eosinophilic esophagitis
T2 - A prospective study
AU - Gupta, Sandeep
AU - Fitzgerald, J. F.
AU - Chong, S. K F
AU - Croffie, Joseph
AU - Ellett, M. E.
PY - 1996
Y1 - 1996
N2 - Introduction: Last year we reported a previously unpublished endoscopic finding in children with eosinophilic/peptic esophagitis, viz VLEM (Gastrointest Endoscopy 1995;41:338). Aim: We now present data from a prospective study of this possible association and report on it's response to therapy. Methods: Endoscopists recorded the findings for each esophagogastroduodenoscopy (EGD) (n322) performed between 6/1/95-11/30/95 on a standard form. Histological assessments of esophageal mucosal biopsies were recorded. Results: VLEM were observed in 22 patients (pts) (ages 3mo-17 yrs) (12 new pts) who underwent 27 EGDs during the study period. Esophageal mucosal biopsies were obtained for histological study during each of these EGDs. VLEM were observed on 25 EGDs. 23/25 (92%; specificity 0.96, sensitivity 0.54) cases had eosinophilic esophagitis. 20/23 (87%) were subjectively graded moderate or severe by the pathologists. 14/22 pts underwent ≥1 EGDs. VLEM and histological findings were unchanged in 10/14 pts on follow up (f/u) (mean 6.7mo, range 2-19 mo) and improved/resolved in 3/14 on f/u (mean 12.3mo, range 5-27 mo). In one pt, VLEM appeared on repeat EGD (2 mo later) while the histology improved. All pts had received similar therapy (promotility agent and aggressive acid-suppression) and 11/14 reported symptomatic improvement. Conclusions: In this prospective study, we have confirmed our earlier retrospective observation of the positive correlation between VLEM and histological eosinophilic/peptic esophagitis. Additionally, the data suggests that VLEM and the associated histological abnormalities are generally slow to respond to therapy inspite of symptomatic improvement. Thus, prolonged therapy with endoscopie monitoring may be indicated. The long term implication(s) of these observations awaits further study.
AB - Introduction: Last year we reported a previously unpublished endoscopic finding in children with eosinophilic/peptic esophagitis, viz VLEM (Gastrointest Endoscopy 1995;41:338). Aim: We now present data from a prospective study of this possible association and report on it's response to therapy. Methods: Endoscopists recorded the findings for each esophagogastroduodenoscopy (EGD) (n322) performed between 6/1/95-11/30/95 on a standard form. Histological assessments of esophageal mucosal biopsies were recorded. Results: VLEM were observed in 22 patients (pts) (ages 3mo-17 yrs) (12 new pts) who underwent 27 EGDs during the study period. Esophageal mucosal biopsies were obtained for histological study during each of these EGDs. VLEM were observed on 25 EGDs. 23/25 (92%; specificity 0.96, sensitivity 0.54) cases had eosinophilic esophagitis. 20/23 (87%) were subjectively graded moderate or severe by the pathologists. 14/22 pts underwent ≥1 EGDs. VLEM and histological findings were unchanged in 10/14 pts on follow up (f/u) (mean 6.7mo, range 2-19 mo) and improved/resolved in 3/14 on f/u (mean 12.3mo, range 5-27 mo). In one pt, VLEM appeared on repeat EGD (2 mo later) while the histology improved. All pts had received similar therapy (promotility agent and aggressive acid-suppression) and 11/14 reported symptomatic improvement. Conclusions: In this prospective study, we have confirmed our earlier retrospective observation of the positive correlation between VLEM and histological eosinophilic/peptic esophagitis. Additionally, the data suggests that VLEM and the associated histological abnormalities are generally slow to respond to therapy inspite of symptomatic improvement. Thus, prolonged therapy with endoscopie monitoring may be indicated. The long term implication(s) of these observations awaits further study.
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M3 - Article
VL - 43
SP - 327
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 4
ER -