The Usefulness of the Eosinophilic Esophagitis Histology Scoring System in Predicting Response to Proton Pump Inhibitor Monotherapy in Children with Eosinophilic Esophagitis
Jovan Jevtić,
Nina Ristić,
Vedrana Pavlović,
Jovana Svorcan,
Ivan Milovanovich,
Milica Radusinović,
Nevena Popovac,
Ljubica Simić,
Aleksandar Ćirović,
Miloš Đuknić,
Maja Životić,
Nevena Poljašević,
Danilo Obradović,
Jelena Filipović,
Radmila Janković
Affiliations
Jovan Jevtić
Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Nina Ristić
Department of Gastroenterology, Hepatology and GI Endoscopy, University Children’s Hospital, 11000 Belgrade, Serbia
Vedrana Pavlović
Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Jovana Svorcan
Department of Gastroenterology, Hepatology and GI Endoscopy, University Children’s Hospital, 11000 Belgrade, Serbia
Ivan Milovanovich
Department of Gastroenterology, Hepatology and GI Endoscopy, University Children’s Hospital, 11000 Belgrade, Serbia
Milica Radusinović
Department of Gastroenterology, Hepatology and GI Endoscopy, University Children’s Hospital, 11000 Belgrade, Serbia
Nevena Popovac
Department of Gastroenterology, Hepatology and GI Endoscopy, University Children’s Hospital, 11000 Belgrade, Serbia
Ljubica Simić
Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Aleksandar Ćirović
Institute of Anatomy, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Miloš Đuknić
Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Maja Životić
Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Nevena Poljašević
Department of Pathology, University Clinical Center Tuzla, 75000 Tuzla, Bosnia and Herzegovina
Danilo Obradović
Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Jelena Filipović
Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Radmila Janković
Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Background: Eosinophilic esophagitis (EoE) is an immune-mediated esophageal disease with rising incidence. While proton pump inhibitors (PPIs) are the first-line treatment, a significant proportion of patients do not respond. This study aimed to determine if the EoE Histology Scoring System (EoEHSS) can predict PPI responsiveness. Methods: A cross-sectional study was conducted on 89 pediatric patients diagnosed with EoE between 2016 and 2022. Patients were categorized into PPI responders (PPIREoE) and non-responders (PPINREoE) based on post-treatment biopsies. EoEHSS values from biopsies of the esophagus (distal, middle, and proximal segments) were compared between the two groups. Results: No significant differences in EoEHSS scores were observed for the distal and proximal esophagus between the groups. However, the middle esophagus showed a significantly higher EoEHSS grade score in the PPINREoE group, indicating a more pronounced disease severity. Specific histological features, particularly eosinophilic abscesses and surface layering of the middle segment of the esophagus, were significantly different between the groups. Conclusions: Performing a biopsy of each esophageal segment, particularly the middle, is crucial for diagnostic precision and predicting PPI responsiveness. The EoEHSS can serve as a valuable tool in predicting therapy response, emphasizing the need for personalized therapeutic approaches in EoE management.
