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- W1537548850 abstract "Sirs, We appreciate the interest of Dr Katz in our paper describing a possible link between oesophageal eosinophilia and noncardiac chest pain.1 Dr Katz raises an important point.2 We do not know if the eosinophilic infiltration in our patients with noncardiac chest pain (NCCP) is a cause of the symptom or represents an epiphenomenon. Our study design was not directed at addressing this question. The aim of our study was (as noted in the introduction) ‘to determine the prevalence of abnormal eosinophilic infiltration in patients with NCCP’.1 As pointed out in our discussion ‘our study findings are limited by lack of information on therapeutic outcome as this was not the aim of our study. It would be of considerable interest to know whether these patients will respond to a therapeutic trial…We are in the process of collecting and expanding this information’.1 We agree that only a prospective therapeutic trial can answer this key question. Dr Katz also raises another valid question. He wonders whether he has missed the association between eosinophilic infiltration and chest pain. We speculate that we (and perhaps he) may have. As most patients did not have the expected obvious endoscopic signs of eosinophilic esophagitis (such as prominent furrows or narrow oesophagus), unless oesophageal biopsies are systematically obtained from these patients, the association will be missed. We believe that our observation of eosinophilic infiltration in this setting warrants further investigation. Whether they are the cause of chest pain or not, we do know that eosinophils are not ‘normal’ in the healthy squamous epithelium. We suspect that the eosinophil infiltration observed could be secondary to gastroesophageal reflux disease, but allergy may also play a role in a predisposed individual. We do not know what the eosinophils are doing to the oesophagus in this syndrome. Do they have a more ‘virulent role’ in the pathogenesis or are they an innocent bystander? We look forward to further work on these issues. Declaration of personal and funding interests: None." @default.
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- W1537548850 date "2011-06-02" @default.
- W1537548850 modified "2023-09-22" @default.
- W1537548850 title "Eosinophilic oesophagitis in noncardiac chest pain: authors’ reply" @default.
- W1537548850 cites W1562368232 @default.
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- W1537548850 doi "https://doi.org/10.1111/j.1365-2036.2011.04698.x" @default.
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