Eosinophilic Esophagitis (6 of 6)

One of the fascinating issues in eosinophilic esophagitis is
understanding the causes of eosinophilic infiltration of the
esophagus, an organ normally devoid of eosinophils as
compared with blood and the remainder of the
gastrointestinal tract.

Eosinophilic esophagitis can be suspected clinically, but
diagnosis requires pathologic confirmation by finding large
numbers of intraepithelial eosinophils throughout the
esophagus. The etiology of eosinophilic esophagitis is
unknown but atopy and eosinophilia are common,
suggesting that eosinophilic infiltration of the esophagus
may be a response to environmental allergens, leading to
esophageal inflammation by the release of a variety of
interleukins and cytotoxic proteins

Eosinophils (5-10 per high power field) in the distal
esophagus is characteristic of reflux esophagitis, but large
numbers of eosinophils (>20 per high power field)
infiltrating the esophagus is distinctly unusual.