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Newly Developed And Validated Eosinophilic Esophagitis Histology Scoring System And Evidence That It Outperforms Peak Eosinophil Count For Disease Diagnosis And Monitoring, Margaret H. Collins, Lisa J. Martin, Eileen Steinle Alexander, J Todd Boyd, Rachel Sheridan, Hua He, Scott Pentiuk, Philip E. Putnam, J Pablo Abonia, Vincent A. Mukkada, James P. Franciosi, Marc E. Rothenberg
Newly Developed And Validated Eosinophilic Esophagitis Histology Scoring System And Evidence That It Outperforms Peak Eosinophil Count For Disease Diagnosis And Monitoring, Margaret H. Collins, Lisa J. Martin, Eileen Steinle Alexander, J Todd Boyd, Rachel Sheridan, Hua He, Scott Pentiuk, Philip E. Putnam, J Pablo Abonia, Vincent A. Mukkada, James P. Franciosi, Marc E. Rothenberg
Faculty Scholarship
Eosinophilic esophagitis is diagnosed by symptoms, and at least 15 intraepithelial eosinophils per high power field in an esophageal biopsy. Other pathologic features have not been emphasized. We developed a histology scoring system for esophageal biopsies that evaluates eight features: eosinophil density, basal zone hyperplasia, eosinophil abscesses, eosinophil surface layering, dilated intercellular spaces, surface epithelial alteration, dyskeratotic epithelial cells and lamina propria fibrosis. Severity (grade) and extent (stage) of abnormalities were scored using a 4 point scale (0 normal; 3 maximum change). Reliability was demonstrated by strong to moderate agreement among 3 pathologists who scored biopsies independently (p≤0.008). Several features …