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Symptoms
Endoscopic
Assessment
Histologic
Assessment
Exclusion of
Non-EoE Disorders
Symptoms
Difficulty swallowing, chest pains, and comorbidity of food allergy to shellfish all reflect a clinical presentation suggestive of EoE
Endoscopic Assessment
Recent food impaction and EREFS total score of 5 out of 8 reflect upper endoscopic findings, which increase suspicion for EoE
Histologic Assessment
Esophageal eosinophilia of 40 eos/hpf is above the 15 eos/hpf threshold necessary to confirm EoE diagnosis
Exclusion of
Non-EoE Disorders
Lack of GERD excludes a common non-EoE disorder that may be present in patients with EoE
Proton
Pump
Inhibitor
Swallowed
Topical
Corticosteroid
Empiric
Elimination
Diet
Elemental
Diet
Esophageal
Dilation
Proton
Pump
Inhibitor
Swallowed
Topical
Corticosteroid
Empiric
Elimination
Diet
Elemental
Diet
Esophageal
Dilation
Histology
Symptoms
Endoscopy
Histology
The only currently available quantitative
threshold of adequate therapeutic response is
defined as <15 eos/hpf in esophageal mucosa1,2
Additional prospective,
long-term studies
are needed to confirm that reduction in
esophageal eosinophilia prevents progressive
disease remodeling2
Symptoms
Symptom assessment can be challenging due to use
of non-validated instruments and behavioral
adaptations that mask symptoms1,2
Symptoms do not correlate accurately with
histologic disease activity1
EoE activity should not be assessed based only
on symptoms1
Endoscopy
Endoscopic esophageal biopsies continue to be
necessary to accurately monitor disease
activity1
Follow-up endoscopy after a
6-to-12-week
course of treatment has been suggested; however,
the recommended frequency of EGD with biopsy
during clinical follow-up may vary1,2
Although disease remission is currently anchored in
histologic criteria, symptoms and pathology outcomes are
often discordant with one another1,2
Comprehensive assessment of disease activity needs to
include patient-reported symptom outcomes and objective
measures of endoscopic findings1,2
Daniel Did Not Achieve
Histologic
Remission
(≥15 eos/hpf)
Daniel Achieved
Histologic Remission
(<15 eos/hpf)
With Persistent Symptoms
or Endoscopic Findings
Daniel Achieved
Histologic Remission
(<15 eos/hpf)
With Symptomatic
and Endoscopic Relief
Symptoms
Endoscopic Assessment
Histologic Assessment
Exclusion of
Non-EoE Disorders
Histology
Symptoms
Endoscopy
Maintenance Therapy
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