A New Way to Diagnose Eosinophillic Esophagitis
Eosinophillic Esophagitis (EOE) is a condition that can closely mimic the symptoms of GERD. Many patients are only made aware of an EoE diagnosis after their doctor does a scope and biopsies the tissue lining the esophagus. It has been standard practice to then count the number of eosinophils present in order to make the EoE diagnosis.
Problems can arise in counting eosinophils to diagnose EoE because even severe GERD can produce significant amount of eosinophils. While it is thought that EoE produces more eosinophils than GERD it can still be difficult to distinguish between the two at times. While both diseases have similar symptoms the course of treatment is different so accurate diagnosis is essential.
A recent study has indicated that a new marker might be helpful, even more than simply counting the eosinophils. This marker is tryptase and is found on mast cells which are another kind of inflammatory cell. This study indicated that the EoE patients had not only a higher number of tryptase positive mast cells but that those cells were also distributed more frequenty and evenly throughout the biopsies of tissue.
What the researchers concluded was that "patients with EoE have substantially higher levels of tryptase positive mast cells in the lining of the esophagus, and that staining for tryptase, above and beyond counting the eosinophils, may be useful in determining whether a patient has EoE." (1). This is a very important discovery in diagnosing a disease that is often elusive and confusing.