CHROMOENDOSCOPY WITH IODINE-POTASSIUM IODINE SOLUTION IMPROVES THE DETECTION OF EOSINOPHILIC ESOPHAGITIS

Aims Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition characterized by eosinophilic infiltration of the esophageal mucosa. Endoscopic findings in EoE may be non-specific. The diagnosis is confirmed on histology. Multiple biopsies from≥2 segments are generally recommended but are occasionally negative due to a patchy distribution of EoE. This study aimed to evaluate whether chromoendoscopy with Iodine-Potassium iodine (IPIS) in the esophagus can improve the detection of EoE.

Methods Patients with dysphagia and suspected EoE underwent gastroscopy with IPIS 1% staining of the esophagus. An adequate number of biopsies were taken in≥2 segments of the esophagus. In patients with heterogeneous staining from IPIS, selective biopsies were taken from areas with and without IPIS staining.

Results 50 patients were included, of whom 30 had histologically proven EoE. All patients with EoE had diminished uptake of IPIS. Among patients with EoE, five had segmental and nine had a patchy disease. Six patients with other esophageal mucosa diseases, but no EoE had diminished uptake of IPIS. In patients with segmental or patchy EoE, the median number of eosinophils was significantly higher in areas with diminished uptake of IPIS, compared to areas with normal uptake (86 versus 7 eosinophils/high power field, p=0.01).

Conclusions Chromoendoscopy with IPIS may be an useful in vivo technique for identifying EoE during endoscopy, and may allow targeted biopsies in patients with segmented or patchy disease.

Publication History

Article published online:
14 April 2022