Application of the Eosinophilic Esophagitis Histology Scoring System Grade Scores in Patients at British Columbia Children’s Hospital

Abstract

Introduction

Histologic diagnosis of eosinophilic esophagitis (EoE) involves peak eosinophil counts (PEC) being greater than 15 per high power field. The EoE Histology Scoring System (EoEHSS) was developed to comprehensively evaluate biopsies to better predict symptom and endoscopy response; we aimed to validate the EoEHSS in our provincial registry, where EoEHSS had not been employed.

Methods

We reviewed 186 esophageal biopsies from 16 patients at diagnosis and follow-up. Statistical analyses were conducted to quantify how grade scores correlate with active EoE status and PEC counts, and each feature’s ability to predict active disease.

Results

Nearly all EoEHSS variables were associated with active EoE and high PEC, with basal zone hyperplasia, eosinophil abscesses, and surface epithelial alteration being most predictive in identifying active EoE.

Conclusions

We validated and demonstrated each EoEHSS variable’s strength in tracking traditional PEC counts, resulting in its adoption as a standard reporting element for our research registry.

Keywords:

• eosinophilic esophagitis
• histology scoring system
• pediatric
• validation
• predictive value

Acknowledgments

The authors would like to thank Ms. Michelle Dittrick, Pathology Research Manager at BC Children’s Hospital for help with ethics and administrative roles.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.