Eosinophilic esophagitis in adults in Saudi Arabia: Clinical, endoscopic, and histopathologic characteristics at a large academic center
Nouf Turki, Assim A Felemban, Ibrahim Balubaid, Hani A Jawa, Ahmed Bakhshwin, Abdullah M. Alghamdi, Alshaimaa M. Alsaati, Sulaiman A. Hanbazazah, Ammar Nasser Alharbi, Shorooq BanjarABSTRACT
Background:
In Saudi Arabia, there is still a dearth of research on eosinophilic esophagitis (EoE), particularly in the adult population. Since much of the available research has focused on adolescent populations, there is a significant information gap about the clinical features, diagnostic patterns, and treatment outcomes of Saudi adults.
Purpose:
This study aimed to describe the clinical, endoscopic, and histopathologic features of adult EoE patients at a large academic center in Saudi Arabia.
Subjects and Methods:
A retrospective review of 30 adult patients diagnosed with EoE between January 2014 and January 2024 was conducted. Diagnosis was confirmed by histologic eosinophil counts ≥15 eosinophils per high-power field in esophageal biopsies combined with compatible clinical and endoscopic findings. Data on demographics, symptoms, comorbidities, endoscopy, histopathology, and treatments were extracted.
Results:
The mean age was 34.4 ± 13.9 years, with 58.6% males. Dysphagia (46.7%) and gastroesophageal reflux symptoms (36.7%) were common presentations. Food bolus obstruction occurred in 23.3%. Associated atopic conditions included allergic rhinitis (20%) and asthma (13.3%). Endoscopy revealed linear furrows (63.3%) and trachealization (60%). Histopathology showed eosinophil microabscesses in 80%, surface layering in 83.3%, and universal basal zone hyperplasia. Treatment mainly involved proton pump inhibitors and corticosteroids.
Conclusion:
Adult EoE in this Saudi cohort showed clinical, endoscopic, and histopathologic features that partly overlap with those reported in Western cohorts, although interpretation is limited by the retrospective design and small sample size.