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Volume 133, Issue 4, Pages (October 2007)

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1 Volume 133, Issue 4, Pages 1342-1363 (October 2007)
Eosinophilic Esophagitis in Children and Adults: A Systematic Review and Consensus Recommendations for Diagnosis and Treatment  Glenn T. Furuta, Chris A. Liacouras, Margaret H. Collins, Sandeep K. Gupta, Chris Justinich, Phil E. Putnam, Peter Bonis, Eric Hassall, Alex Straumann, Marc E. Rothenberg  Gastroenterology  Volume 133, Issue 4, Pages (October 2007) DOI: /j.gastro Copyright © 2007 AGA Institute and North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Terms and Conditions

2 Figure 1 Endoscopic findings associated with eosinophilic esophagitis. (A) Mucosal rings representative of transient contractions or fixed structures. This appearance has also been termed feline esophagus, trachealization, or concentric rings. (B) Whitish exudates scattered across the mucosal surface. These represent eosinophilic purulence burgeoning through the esophageal epithelium. Exudates can appear as punctate white nodules, dispersant flocculant material, or in a granular pattern and can occur along the length of the esophagus. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2007 AGA Institute and North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Terms and Conditions

3 Figure 2 Esophageal furrowing representative of mucosal edema and thickening. (A) Furrows encompass the entire luminal surface of the distal esophagus with a very thick and almost nodular appearance. (B) In this Figure, the most prominent furrowing occurs preferentially along the left lateral wall. (C) Vertical lines course along the length of the esophageal mucosa. This finding is often most prominent when the esophagus is inflated. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2007 AGA Institute and North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Terms and Conditions

4 Figure 3 Eosinophilic esophageal inflammation in eosinophilic esophagitis. (A) Low-power view of the epithelium showing increased numbers of eosinophils and evidence of basal zone hyperplasia and elongated rete papillae. (B) High-power view of the epithelium demonstrating large numbers of eosinophils accumulating preferentially toward the luminal surface along with a thickened basal zone. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2007 AGA Institute and North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Terms and Conditions

5 Figure 4 Eosinophilic microabscess associated with eosinophilic esophagitis. (A) Low-power view of an eosinophilic microabscess with superficial layering of eosinophils along the luminal surface. (B) Low-power view of 2 massive eosinophil abscesses along luminal border of esophagus. These occur on a base of hyperplastic epithelium. (C) High-power view of eosinophil microabscess. Inferior to the abscess are a number of eosinophils, some of which appear degranulated. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2007 AGA Institute and North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Terms and Conditions


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