Esophagitis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ajay Gade MD[2]]

Overview

A complete blood count (CBC) is performed in patients with neutropenia or who are immunosuppressed. A CD4 count and HIV test are performed in patients with risk factors for HIV. A collagen workup (eg, antinuclear antibody [ANA], anti-dsDNA) may be performed based on the underlying disease.

Laboratory Findings

Eosinophilic Esophagitis

Laboratory findings of the EoE are as follows:

• There are no specific diagnostic markers to diagnose EoE patients.
• Although not specific, elevated serum IgE level is identified in majority patients.
• Increased peripheral eosinophil count is also seen in the majority of patients.

• There are 3 main ways in which food allergies can be detected in EoE are as follows:

Test	Procedure	Interpretation
Skin prick testing	A small amount of allergen is introduced into the skin of the patient through a gentle puncture with a pricking device.	Causes type-1 hypersensitivity reaction An area of redness and swelling around the prick.
Atopy patch testing	A small amount of a fresh food in a small aluminum chamber called a Finn chamber. The Finn chamber is then taped on the person’s back. The food in the chamber stays in contact with the skin for 48 hours. It is then removed and the allergist reads the results at 72 hours. The results from the food patch test helps the physician to determine which foods can be avoided	A positive delayed reaction to the food is determined by the inflamed area of the skin around the Finn chamber. This is more useful in the pediatric population than in the adults.

Reflux Esophagitis

Ambulatory reflux monitoring

• GERD is mostly diagnosed clinically by the presenting typical symptoms which include heartburn, regurgitation, and dysphagia.
• Correlation of the GERD symptoms with confirmed acid presence by the ambulatory reflux monitoring is strongly suggestive of GERD.
• Ambulatory reflux monitoring is recommended by the American College of Gastroenterology (ACG) as the only laboratory test to determine the presence of acidic reflux in the esophagus.
• Indications of ambulatory reflux monitoring include the following:
  • GERD diagnosis if it is not confirmed
  • Determine the time of reflux occurrence
  • Refractory GERD symptoms
  • Preoperative for non-erosive disease
• Ambulatory reflux monitoring is performed in either two ways which include:
  • Telemetry capsule (48 hours monitoring)
  • Transnasal catheter (24 hours monitoring)