Barrett’s Esophagus With Dysplasia and Persistent Eosinophilic Esophagitis After Radiofrequency Ablation

24 Jan 2024 04:00 06:00
Houston, Texas
Mehnaz Shafi Host

Patient Profile & Clinical History

  • Patient: 55-year-old man

  • Medical History: Chronic gastroesophageal reflux disease (GERD).

  • Initial Diagnosis: Barrett’s esophagus with low-grade dysplasia (Prague C8M8).

  • Endoscopic Eradication Therapy: Successful radiofrequency ablation (RFA) with complete resolution of intestinal metaplasia.

  • Surveillance Findings: Intense eosinophilia (> 50/HPF) on surveillance biopsies.

  • EoE Management: Multiple inhaled and oral steroid treatments with persistent eosinophilic esophagitis (EoE).

Endoscopic & Diagnostic Findings

  • Barrett mucosa.

  • 24-hour pH image.

  • CW MRS.

  • CW RDC.

  • CW supine.

  • CW upright.

Panel for Discussion: The MD Anderson Profile

Mehnaz A. Shafi | George Triadafilopoulos | Deyali Chatterjee | Abdullah Shaikh

Key Discussion Points

  1. Therapy for GERD, EoE, and Barrett’s esophagus with dysplasia

  2. Technical aspects for ablation of BE using RFA in the background of EoE

  3. Esophageal eosinophilia after radiofrequency ablation for Barrett’s esophagus

  4. Endoscopic findings of EoE

  5. Pathologic findings in Barrett’s with dysplasia and EoE

  6. Role of Dupixent and recent developments in EoE

  7. Role of PPI and diet in EoE