Diagnosis
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History
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Difficulty swallowing, chest pains; cuts food into small pieces during meals
Endoscopy with EREFS total score of 5, following recent ER visit due to food impaction
Six esophageal biopsies showed esophageal eosinophilia of 40 eos/hpf
Allergic to shellfish; no GERD
Case based on hypothetical patient.
eos/hpf, eosinophils per high-power field; ER, emergency room;
EREFS, Endoscopic Reference Score; GERD, gastroesophageal reflux disease.
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Diagnostic Images:
Esophageal ENDOSCOPIC
EREFS Findings
EREFS Score1:
5 out of 8
Reproduced from Gut, Hirano I, et al, Volume 62/Issue 4, Endoscopic assessment of the
oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading
system, pp489-495, Copyright 2013 with permission from BMJ Publishing Group, Ltd.
Case based on hypothetical patient.
EREFS, Endoscopic Reference Score, total scores range from 0 to 8 (higher scores indicate greater
impairment).1
1. Hirano I, et al. Gut. 2013;62(4):489-495.
Diagnostic Images:
Esophageal Biopsies
Esophageal
eosinophil count:
40
eos/hpf*
Reprinted from Postgraduate Medical Journal, Bystrom JB and O'Shea NR, Volume 90/Issue 1063,
Eosinophilic oesophagitis: clinical presentation and pathogenesis, pp282-289, Copyright 2014, with
permission from BMJ Publishing Group, Ltd.
Case based on hypothetical patient.
*Representative images from 6 biopsies taken from distal and proximal sections of the esophagus
during esophagogastroduodenoscopy.
eos/hpf, eosinophils per high-power field; H&E, hematoxylin and eosin.
1. Bystrom JB, O’Shea NR. Postgrad Med J. 2014;90(1063):282-289.