Eosinophilic esophagitis (EoE) is a chronic inflammatory condition requiring periodic endoscopic examinations to determine therapeutic response. As a result, impacted children face substantial healthcare expenditures and a procedural load. There were no noninvasive alternative techniques for reassessing disease activity. Adults with EoE have low baseline impedance as assessed by multichannel pH impedance (pH-MII), which is consistent with poor mucosal integrity. For a study, researchers sought to determine the link between esophageal eosinophilia (or the degree of eosinophilic infiltration) and baseline impedance in children with EoE.
They identified 15 children with EoE at the institution who had pH-MII within 30 days of a three-level esophageal biopsy. The group was not given proton pump inhibitors at the same time and had insignificant pH-MII reflux values. Upper, mid, and lower esophageal average impedance baselines were computed using baseline impedance automated analysis (RIAA) and mean nocturnal baseline impedance (MNBI) techniques. The EoE group’s eosinophil count data for the upper, mid, and lower esophageal segments were compiled.
On nonparametric testing, children with EoE exhibited substantially lower baseline impedance over the esophagus length as compared to 30 controls who had no differences in age or reflux load. No correlation was found between baseline impedance and eosinophil number in corresponding esophageal regions. In clinical practice, baseline impedance may be an essential, less intrusive adjunct to assessing therapy response in children with EoE. Therefore, larger prospective cohort studies should be conducted to determine the most accurate baseline impedance thresholds for active and inactive illness.