Eosinophilic esophagitis (NORD)

00:00 / 00:00

Videos

Notes

Eosinophilic esophagitis (NORD)

Information for patients and families

Osmosis

Using an inhaler: Information for patients and families

Managing diabetes during the holidays: Information for patients and families

The flu vaccine: Information for patients and families

Bike helmet safety: Information for patients and families

The Primary School

Toxic stress: Information for patients and families (The Primary School)

ADHD: Information for patients and families (The Primary School)

Asthma: Information for patients and families (The Primary School)

Childhood nutrition and obesity: Information for patients and families (The Primary School)

Childhood oral health: Information for patients and families (The Primary School)

Food allergies and EpiPens: Information for patients and families (The Primary School)

Glut1 Deficiency Foundation

Glut1 deficiency syndrome (Glut1 Deficiency Foundation)

The National Organization for Rare Disorders (NORD)

Narcolepsy (NORD)

Adrenoleukodystrophy (NORD)

Zellweger spectrum disorders (NORD)

Glycogen storage disease type II (NORD)

Metachromatic leukodystrophy (NORD)

Gaucher disease (NORD)

Niemann-Pick disease types A and B (NORD)

Fabry disease (NORD)

Tay-Sachs disease (NORD)

Mucopolysaccharide storage disease type 1 (Hurler syndrome) (NORD)

Mucopolysaccharide storage disease type 2 (Hunter syndrome) (NORD)

Phenylketonuria (NORD)

Cystinuria (NORD)

Aromatic L-amino acid decarboxylase deficiency (NORD)

Cerebrotendinous xanthomatosis (NORD)

Classical homocystinuria (NORD)

Autoimmune polyglandular syndrome type 1 (NORD)

Thyroid eye disease (NORD)

Opsoclonus myoclonus syndrome (NORD)

Thyroid eye disease (NORD)

Short bowel syndrome (NORD)

Bile synthesis disorders (NORD)

Eosinophilic esophagitis (NORD)

Cyclic vomiting syndrome (NORD)

Polycythemia vera (NORD)

Essential thrombocythemia (NORD)

Myelofibrosis (NORD)

Warm autoimmune hemolytic anemia and cold agglutinin (NORD)

Sickle cell disease (NORD)

Waldenstrom macroglobulinemia (NORD)

Post-transplant lymphoproliferative disorders (NORD)

Cytomegalovirus infection after transplant (NORD)

Congenital athymia (NORD)

Severe chronic neutropenia (NORD)

Mycobacterium avium complex (NORD)

Congenital cytomegalovirus (NORD)

Opsoclonus myoclonus syndrome (NORD)

Spinocerebellar ataxia (NORD)

Early infantile epileptic encephalopathy (NORD)

IgA nephropathy (NORD)

Focal segmental glomerulosclerosis (NORD)

Alagille syndrome (NORD)

NGLY1 deficiency (NORD)

PIK3CA-related overgrowth spectrum (NORD)

Recurrent pericarditis (NORD)

Gorlin Syndrome Alliance

Gorlin syndrome (Gorlin Syndrome Alliance)

Assessments

Eosinophilic esophagitis (NORD)

USMLE® Step 1 questions

0 / 2 complete

Questions

USMLE® Step 1 style questions USMLE

of complete

A 65-year-old woman comes to the clinic due to difficulty swallowing and retrosternal pain. For the past 2 days, she has had pain with swallowing which has progressively worsened to the point of avoiding all food and drinks. She has not had similar symptoms in the past. Medical history is significant for coronary artery disease, hyperlipidemia, seasonal allergies, and osteoarthritis. The patient has smoked 1 pack of cigarettes per day for 30 years. Medications include aspirin, metoprolol, loratadine, lovastatin, and piroxicam as needed. Temperature is 37.0°C (98.6°F), pulse is 80/min, and blood pressure is 125/85 mmHg. The oral mucosa is clear without erythema or exudate. Cardiac auscultation reveals no murmurs, and ECG shows normal sinus rhythm without ischemic changes. The rest of the physical examination is normal. Endoscopy is obtained and shows multiple round ulcers in the proximal esophagus with relatively normal surrounding tissue. Which of the following is the most likely diagnosis?  

Transcript

Content Reviewers

Kelly Johnson, MS

Contributors

Jerry Ferro

Alaina Mueller

Megan Gullotto, MSMI

Eosinophilic esophagitis, or EoE, is a chronic food allergy associated digestive disorder in which people have large numbers of eosinophils in the esophagus. Eosinophils are a type of white blood cell that play many roles within the immune system and are involved in allergic reactions.

Signs and symptoms of eosinophilic esophagitis can vary quite a bit, and are frequently the same as those for gastroesophageal reflux disease, also known as GERD.

These symptoms are caused by increased inflammation and swelling within the esophagus, and include trouble swallowing, food getting stuck in the throat, nausea, vomiting, poor growth in childhood, weight loss, stomach pain, poor appetite, and malnutrition.

The increase in eosinophils in the esophagus can be caused by a number of things, particularly hypersensitivity reactions or changes to the expression of certain genes.

The hypersensitivity reactions involved are a form of allergic reaction after exposure to a food or environmental allergen. When certain cells come in contact with the allergen they signal other cells, most commonly eosinophils, to accumulate and get activated in the esophagus.

The first exposure to an allergen may take time to create a response. However, some cells remember that allergen to more quickly react to future exposures.

Therefore, the more a person is exposed to allergens which trigger a hypersensitivity reaction, the more eosinophils will be present.

Additionally, changes to gene expression appear to play a role in increasing the number of eosinophils in a person with EoE.

Summary

Eosinophilic esophagitis (EoE) is a rare, chronic disease that causes inflammation in the esophagus. The eosinophils are a type of white blood cell that play an important role in the immune system. In EoE, these cells accumulate in the lining of the esophagus, causing inflammation and damage. EoE is associated with other allergic diseases such as asthma. Its symptoms vary from person to person but may include difficulty swallowing (dysphagia), chest pain, nausea, vomiting, and weight loss.

Elsevier

Copyright © 2023 Elsevier, except certain content provided by third parties

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.

RELX