broaden your horizons (a.k.a. good luck diagnosing this one in the ED): EE

RAGING HYPOTHETICAL:
--patient with esophageal foreign body, mobilizing for GI swallow/scope
--foreign body resolved by the time GI swallow is done
--GI consult requests IgE... why?




Eosinophilic Esophagitis (EE) 


--mimics GERD and may result in narrowing or stricture of the esophagus.  


--differentiated from GERD by the amount of mucosal eosinophilia and lack of response to acid suppression.  


--In a cohort, 71% percent of patients with EE were male with a mean age of 10.5+/-5.4 years.  


--strong familial pattern 


--sometimes first presents with lodged food boluses 2/2 stricture.  




Submitted by T. Boyd.




Reference(s): Noel et al. Eosinophilic Esophagitis Correspondence. NEJM. 351:940-941. Aug 2004. picture