Background and study aim: Eosinophilic esophagitis (EoE) is an immune-allergic mediated clinicopathologic condition characterized by symptoms of esophageal dysfunction with prominent eosinophilic infiltrate in the esophageal mucosa. Interleukin-5 (IL-5) play a role in eosinophil esophageal trafficking in EoE patients. This study aimed to assess serum interleukin-5 as an indicator of EoE in patients with chronic upper GIT symptoms. Patients and Methods: This study included 80 adults with at least one of chronic upper GIT symptoms not responded to standard daily PPI therapy for 8 weeks, in whom upper GIT endoscopy was done with histopathological assessment of esophageal biopsies. EoE was diagnosed by detection of ≥15 eosinophils/high power field (HPF). Ten apparently healthy subjects were enrolled as a control group. Interleukin-5 (IL-5) in serum by ELISA was measured in all subjects. Results: By histopathological examination, six patients (7.5%) were diagnosed to have EoE. Endoscopic esophageal furrows, fissures/wrinkles; white exudate/granularity and concentric rings (trachealization) were significantly more frequent in patients with EoE than non EoE. Median concentration of serum IL-5 in EoE patients was 222.2 pg/ml with range 187.5-307 pg/ml while, it was 32.1 pg/ml with range 15.6-113.6 pg/ml in non EoE patients and 11.8pg/ml with range 13.4-38.2 pg/ml in controls with P value < 0.001. ROC curve analysis showed that serum IL-5 can significantly predict EoE at a cut-off value of 103.2 pg/ml with sensitivity 100%, specificity 93.2%, PPV 54.5%, NPV100%, Accuracy 93.8%, AUC = 0.989 and (95%CI) = 0.96-1.0. Conclusion: Serum interleukin-5 could be used as an indicator for eosinophilic esophagitis diagnosis in patients with chronic upper GIT symptoms. However, histopathological diagnosis still necessary. |
