Eosinophilic Esophagitis

Question 1

EoE EGD findings

Answer 1

1. whitish exudates (eosinophilic micro-abscesses)
2. longtudinal furrows
3. trachealization
4. tubular mid-esophageal stricture
5. edema
6. Friability

Question 2

EoE histo findings

Answer 2

1. eosinophilic infiltrates >15/hpf 40x in > 1 eso site
2. basal hyperplasia
3. papillary elongation
4. dilated intercellular space
5. superficial eosinophilic micro-abscesses

Question 3

Rx for EoE

Answer 3

1. high dose PPI
2. Topical steroids (budesonide or fluticasone)
3. 6 food elimination diet (egg, soy, fish/shellfish, nuts, wheat)
4. combined steroids and PPI
5. biologic: emapalumab

Question 4

Short and longterm complications of EoE

Answer 4

1. candial infection
2. food impaction
3. strictures
4. hypo-motility

Question 5

FPIES

Answer 5

Sx: Vomiting, diarrhea, dehydration, lethargy

dx: clinical

Rx: avoid trigger

prognosis: outgrown in toddlerhood

Question 6

IgE mediated (anaphylaxsis)

Answer 6

Sx: hives, other system involvement

Dx: RAST, Skin prick

Rx: avoid trigger, epi pen

prognosis: lifelong