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Eosinophilic esophagitis — ABIM Board MCQ

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ModerateGastroenterology/HepatologyEosinophilic esophagitisABIM Board

A 31-year-old man has recurrent solid-food dysphagia and food impaction. Endoscopy shows rings and linear furrows in the esophagus. Biopsies show 45 eosinophils per high-power field. He has seasonal allergic rhinitis. Which of the following is the most likely diagnosis?

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Correct answer: A — Eosinophilic esophagitis

Intermittent solid-food dysphagia, rings, furrows, atopy, and dense esophageal eosinophilia are typical of eosinophilic esophagitis. Management includes swallowed topical steroids, PPI therapy, dietary approaches, and dilation for strictures when needed.

Reference: ACG Eosinophilic Esophagitis Guideline