An In-Depth Characterization of a Large Cohort of Adult Patients with Eosinophilic Esophagitis (EoE) in a Major East Coast Tertiary Care Center
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Lyvia Leigh, MD, Jonathan M. Spergel, MD PhD FAAAAI
RATIONALE: An in-depth characterization of the adult EoE population and its association with atopic and other comorbid conditions compared with the general and pediatric population. To our knowledge, this is one of the first in-depth analyses of a large adult EoE cohort.

METHODS: Manual retrospective chart review of 1,218 patients with EoE identified by ICD-9/10 codes from the University of Pennsylvania Health Systems. Parameters include age, gender, ethnicity, smoking history, family history of EoE, age at diagnosis, presenting symptom, number of eosinophils/high-powered field (Eos/HPF) on initial and most recent biopsies, peripheral absolute eosinophil count (AEC), serum IgE level, history of food impaction, stricture requiring dilatation, EoE therapy, presence of comorbid atopic or other conditions.

RESULTS: The current cohort is predominantly male (64%), Caucasian (88%) with an average age of 32 years that presented with dysphagia (57%) on diagnosis, 3.5% with family history of EoE (all first degree relatives). On presentation, the average EGD had 50 Eos/HPF; the maximum AEC (mean-472) and IgE (mean-330). Endoscopically, 59% had impaction (38% required endoscopic removal), 42% had strictures/fibrosis (75% underwent dilatation). Therapy used: diet and medical (22%), medical only (71%), and diet only (3%). For atopic conditions, there was asthma (33%); eczema (17%); IgE-mediated food allergy-not including PFAS-(26%); PFAS (31% ); SAR/PAR (74%); medication allergy (25%); anaphylaxis (16%); and Latex allergy (5%). For comorbid conditions, autoimmune disease (9%); H. pylori (3%); psychiatric comorbidity (14%); and never-smokers (80%).

CONCLUSIONS: This EoE cohort shares features seen with pediatric cohorts with increased PFAS and other atopic conditions compared to national averages.