Search

This article discusses a case of eosinophilic angiocentric fibrosis (EAF) with atypical clinical presentation involving the skin and upper respiratory tract. EAF is a rare fibroinflammatory condition that primarily affects the orbit and upper respiratory tract. The patient in this case initially presented with a firm plaque on her thigh, which later became inflamed and coincided with upper respiratory tract infections. The diagnosis was confirmed through skin and nasal mucosa biopsies, which revealed characteristic histopathological findings, including eosinophils and IgG4+ plasma cells. The patient's symptoms improved with treatment using methotrexate and prednisone. This case highlights the importance of recognizing the diverse and atypical manifestations of EAF for accurate diagnosis and management. [Extracted from the article]

Background: Crohn's disease (CD) is a chronic intestinal inflammatory disorder, the etiology of which remains unknown, and is characterized by symptoms such as chronic abdominal pain, diarrhea, obstruction, and perianal lesions. Histopathology is widely regarded as the preferred method for diagnosing CD, although the histological diagnosis may lack specificity. The identification of granulomas is commonly believed to be the most reliable diagnostic indicator for CD, surpassing all other clinical features in significance. Nevertheless, research indicates that the detection rate of granulomas in CD exhibits considerable variability. Furthermore, granulomas can manifest in various specific infections including tuberculosis and Yersinia, as well as in a range of diseases characterized by macrophage reactions such as sarcoidosis and drug-induced enteritis. Granulomas associated with CD typically do not exhibit necrosis. However, the formation of caseous granulomas may occur as a result of secondary infections related to anti-CD drug treatment or perforation of the intestinal wall. Case presentation: In this study, we present a case of a 28-year-old female patient diagnosed with CD exhibiting histologic granulomas, including both caseating and non-caseating forms, which demonstrated a positive response to medical treatment. Conclusion: In clinical practice, various forms of granulomas may indicate diverse underlying diseases, yet lack specificity. It is suggested that the presence of caseous granulomas should not be considered as a definitive exclusion criterion for the diagnosis when clinical, endoscopic, imaging and other histopathological features are consistent with CD. This study is the first report of caseous granulomas in CD without concomitant tuberculosis infection. [ABSTRACT FROM AUTHOR]

Background: Anisakiasis, a zoonotic disease caused by the nematode Anisakis, poses a significant concern for public health, particularly in regions with high consumption of raw or undercooked fish. Case Presentation: We present a case report of a 41-year-old woman who developed severe abdominal symptoms, ultimately diagnosed with intestinal obstruction due to Anisakis infestation, requiring surgery. Despite the absence of prominent eosinophilia or specific radiological findings, the diagnosis was confirmed through histological examination, highlighting the importance of considering anisakiasis in patients with a history of raw seafood consumption. Conclusion: The case underscores the diagnostic challenges associated with anisakiasis, emphasizing the need for increased awareness among healthcare professionals and the public regarding the risks of consuming raw or undercooked seafood. Effective management requires a multidisciplinary approach, including clinical assessment, imaging studies, and histological evaluation, to ensure timely diagnosis and appropriate treatment. [ABSTRACT FROM AUTHOR]

The article discusses the case of a Belgian Malinois dog with colorectal pythiosis with partial obstruction and marked colonic dilatation. Topics discussed include tenesmus, hematochezia, intermittent chronic diarrhea and weight loss presented by the dog, the cytological, histopathological and laboratory findings, and euthanasia performed on the dog due to financial constraints and poor prognosis.

This article presents a case study of an 8-year-old cat with a skull mass diagnosed as osteosarcoma, a type of bone cancer. The mass was found to be located in the right frontoparietal region of the skull and caused a shift in the right cerebral hemisphere. The study discusses the clinical signs, imaging findings, and histopathological examination of the mass. It emphasizes the rarity of skull involvement in osteosarcoma and the importance of advanced imaging techniques in diagnosis. The article also provides information on the prognosis and survival rate associated with different types of osteosarcoma in cats. [Extracted from the article]

Hypereosinophilic syndrome (HES) has substantial clinical heterogeneity and leads to any organ dysfunction and can be fatal without timely treatment. HES is associated with an extremely poor prognosis, with the survival rate at 60 days after intensive care unit (ICU) admission around 20%. A high index of suspicion is needed for timely diagnosis and early initiation of treatment to improve outcomes. Treatment strategies are aimed at symptom control and limiting end-organ damage by lowering blood eosinophils. The combination of immune thrombocytopenic purpura (ITP), deep vein thrombosis (DVT), and cerebral venous sinus thrombosis (CVST) in the setting of eosinophil-related diseases has seldom been reported. Here, we report a case of a young female who developed eosinophilic pneumonia, DVT, CSVT, and ITP managed successfully with steroids, intravenous immunoglobulin, and anticoagulation. [ABSTRACT FROM AUTHOR]

Influenza A virus (IAV) infections in swine are usually subclinical, but they can reach high morbidity rates. The mortality rate is normally low. In this study, six vaccinated, spontaneously deceased sows revealed IAV infection and enhanced neutrophilic bronchopneumonia with unexpectedly large numbers of infiltrating eosinophils. The purpose of this study was to characterize these lung lesions with special emphasis on the phenotypes of inflammatory cells, the presence of eosinophilic peroxidase (EPO), and neutrophil extracellular traps (NETs). The number of Sirius red-stained eosinophils was significantly higher in the lungs of IAV-infected sows compared to healthy pigs, indicating a migration of eosinophils from blood vessels into the lung tissue stimulated by IAV infection. The detection of intra- and extracellular EPO in the lungs suggests its contribution to pulmonary damage. The presence of CD3+ T lymphocytes, CD20+ B lymphocytes, and Iba-1+ macrophages indicates the involvement of cell-mediated immune responses in disease progression. Furthermore, high numbers of myeloperoxidase-positive cells were detected. However, DNA-histone-1 complexes were reduced in IAV-infected sows, leading to the hypothesis that NETs are not formed in the IAV-infected sows. In conclusion, our findings in the lungs of IAV-infected vaccinated sows suggest the presence of so far unreported field cases of vaccine-associated enhanced respiratory disease. [ABSTRACT FROM AUTHOR]

Background: Diascopy is a point‐of‐care diagnostic test used to differentiate skin erythema due to vascular dilation from haemorrhage. In the veterinary literature, only a handful of diseases have been described to be associated with a negative (nonblanching) diascopy result, and histological investigation of haemorrhage has been inconsistent. Objectives: Retrospective study to undertake a histopathological investigation of canine, nonblanching erythematous dermatoses for the presence or absence of haemorrhage and vascular changes. Materials and Methods: Skin biopsies from dogs presented with moderate‐to‐severe nonblanching erythema were evaluated histologically. Additionally, clinical data about each patient were analysed. Results: Twenty cases were identified with nonblanching erythema. Diagnoses included vasculopathy (n = 6), canine eosinophilic dermatitis (n = 3), cutaneous epitheliotropic T‐cell lymphoma (n = 2), and one case each of sterile granuloma and pyogranuloma syndrome, German shepherd dog pyoderma, multiple mast cell tumours, haemangiosarcoma, exfoliative cutaneous lupus erythematosus, canine leishmaniosis with sebaceous adenitis, sebaceous adenitis with concurrent dermatophytosis, calcinosis cutis and canine atopic dermatitis with insect‐bite reaction. One or more vascular changes were present in all 20 cases and included perivascular oedema, endothelial swelling and neutrophilic infiltration of vessel walls. Haemorrhage was identified in 17 of 20 cases (85%). Three cases without dermal haemorrhage were calcinosis cutis, sebaceous adenitis with dermatophytosis and canine atopic dermatitis with insect‐bite reaction. Conclusions and Clinical Relevance: Negative diascopy was associated with haemorrhage and vascular pathological findings in the majority of cases, yet not all. Haemorrhage was identified histologically in all diseases previously reported as nonblanching as well as in a few additional diseases. [ABSTRACT FROM AUTHOR]

The document discusses a case of iatrogenic transmission of vascular Aß40 amyloid, highlighting the prion-like transmission of amyloid in amyloidosis pathogenesis. A 42-year-old male developed cerebral amyloid angiopathy 29 years after receiving a cadaveric dural graft, leading to multiple intracranial hemorrhages. The case is unique due to the detailed clinical course and histological findings, suggesting a probable case of vascular Aß40 amyloid transmission. The study emphasizes the need for further research on iatrogenic transmission of amyloid and effective treatments for cerebral amyloid angiopathy. [Extracted from the article]

This article discusses a case report of a 15-year-old female with scalp and skin lesions caused by syphilis. The patient presented with a firm lump on her forehead and violaceous, brown papules on her scalp, trunk, and extremities. Laboratory tests and imaging confirmed the diagnosis of syphilis, and further examination revealed additional lesions consistent with secondary syphilis. The article emphasizes the variable clinical presentations of syphilis and the importance of early detection and treatment. Treatment options for syphilitic osteitis are also discussed. [Extracted from the article]

This article discusses a case report of a patient with eosinophilic granulomatosis with polyangiitis (EGPA), a rare systemic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The patient presented with a choroidal granuloma near the optic disk, which was highlighted through multimodal imaging. The article describes the patient's medical history, examination findings, and treatment. The authors emphasize the importance of optical coherence tomography (OCT) in diagnosing and imaging retinal pseudo-tumors. This case report provides valuable insights into the ophthalmologic manifestations of EGPA and the utility of multimodal imaging in diagnosing and monitoring the condition. [Extracted from the article]

Objective: SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a highly malignant neoplasm with an undifferentiated or rhabdoid phenotype, posing a diagnostic challenge. This case report aims to create awareness about this rare neoplasm while dealing with cases presenting with undifferentiated morphology. Case Report: A 55-year-old gentleman with constitutional symptoms and lymphadenopathy. Imaging revealed a mass lesion in the right upper lobe of the lung. A biopsy of the cervical lymph node showed diffusely effaced architecture replaced by sheets of undifferentiated pleomorphic cells with vesicular nuclei, prominent nucleoli, eosinophilic cytoplasm, and multiple necrotic foci. An extensive immunohistochemistry (IHC) panel was applied, which showed positivity for synaptophysin, vimentin, and focal CD34 and EMA expression. Other markers like pan-cytokeratin, p40, TTF1, CD56, INSM1, calretinin, CD45, SOX10, S100, CD30, CD117, SMA, and Desmin were negative, with INI1 retained. The IHC panel excluded the morphological differentials of carcinoma, lymphoma, rhabdomyosarcoma, melanoma, and germ cell tumor. Further literature review led to the possibility of the SMARCA4-UT entity, which had a morphology and IHC profile similar to the present case. Testing for SMARCA4 (BRG-1) by IHC showed a complete loss in the tumor cells, favoring the diagnosis of Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT). Conclusion: SMARCA4-UTs are rare, highly aggressive, and poorly differentiated thoracic tumors. Recognizing them is vital as there is potential for therapeutic interventions such as immunotherapy and SMARCA4-targeted therapies, offering promising prospects for the future. [ABSTRACT FROM AUTHOR]

NK/T-cell lymphoma (NKTCL) is a highly aggressive malignant tumour with a very poor prognosis, which often poses diagnostic difficulties due to the non-specificity of its clinical presentation. NK/T-cell lymphoma with eosinophilic hyperplasia syndrome is extremely rare. This article describes a patient with NKTCL misdiagnosed as vasculitis who presented with sinusitis, abdominal pain, anorexia, and lung shadows. Additionally, the patient exhibited extremely high eosinophilia levels, which led to a further misdiagnosis of eosinophilic granuloma. We describe the clinical features, diagnostic methods and differential diagnosis of lymphoma and highlights the importance of a multidisciplinary approach in accurate diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Asthma is a prevalent chronic non-communicable disease, affecting approximately 300 million people worldwide. It is characterized by significant airway inflammation, hyperresponsiveness, obstruction, and remodeling. Eosinophilic asthma, a subtype of asthma, involves the accumulation of eosinophils in the airways. These eosinophils release mediators and cytokines, contributing to severe airway inflammation and tissue damage. Emerging evidence suggests that targeting eosinophils could reduce airway remodeling and slow the progression of asthma. To achieve this, it is essential to understand the immunopathology of asthma, identify specific eosinophil-associated biomarkers, and categorize patients more accurately based on the clinical characteristics (phenotypes) and underlying pathobiological mechanisms (endotypes). This review delves into the role of eosinophils in exacerbating severe asthma, exploring various phenotypes and endotypes, as well as biomarkers. It also examines the current and emerging biological agents that target eosinophils in eosinophilic asthma. By focusing on these aspects, both researchers and clinicians can advance the development of targeted therapies to combat eosinophilic pathology in severe asthma. [ABSTRACT FROM AUTHOR]

This article discusses the lack of detection of aluminum-reactive T-lymphocytes in patients with subcutaneous immunotherapy (SCIT)-induced granulomas. Aluminum contact allergy is commonly seen in children with itching vaccination granulomas, but it can also occur in adults following SCIT. The traditional method of detecting sensitization to aluminum is patch testing, but it has limitations. The study investigates the use of the blood in vitro lymphocyte proliferation test (LPT) as an alternative to patch testing. The results suggest that there may be few or no circulating aluminum-reactive cells in adults with SCIT-induced granulomas, and both patch testing and LPT may have low sensitivity for detecting aluminum contact allergy in adults. [Extracted from the article]

This article discusses a case study of a 72-year-old woman with persistent cutaneous granulomatous lesions on her right arm. Despite numerous treatments, including antibiotics and corticosteroids, the lesions did not improve. The patient was eventually diagnosed with rubella virus (RuV)-associated cutaneous granulomatous disease, which is a rare condition that has been reported in immunocompetent patients. The article highlights the importance of considering RuV infection as a differential diagnosis in cases of cutaneous granulomas of unknown origin, especially when resistant to treatment. Treatment for this condition remains challenging, and further research is needed to develop effective therapies. [Extracted from the article]

Sea urchin injuries are common following accidental contact with sharp sea urchin spines. Immediate manifestations of injury include local erythema, pain, and myalgia. Failure to remove the spines from the skin may result in delayed systemic reactions, secondary infection, granulomas, and—if joint spaces are involved—inflammatory or infectious synovitis and arthritis. The majority of severe complications can be avoided if the spines are fully removed from the skin soon after injury, which can be difficult. This article aims to bring awareness to the myriad complications from sea urchin injuries as well as the mechanisms for successful spine removal. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis (Mtb). When Mtb enters inside the pulmonary alveolus, it is phagocytosed by the alveolar macrophages, followed by a cascade of immune responses. This leads to the recruitment and accumulation of additional macrophages and T cells in the pulmonary tissues. A key outcome of this is the formation of granuloma, the hallmark of TB infection. In this paper, we develop a mathematical model of the evolution of granuloma by a system of partial differential equations that is based on the classical Keller–Segel chemotaxis equation. We investigate the effect of different parameters on the formation of granuloma. We present numerical simulation results that illustrate the impact of different parameters. The implication of our result on the disease progression is also discussed. [ABSTRACT FROM AUTHOR]

Introduction. Recently, an increased risk of celiac disease or eosinophilic esophagitis has been postulated among patients with either of these disorders, prompting some to suggest a common underlying mechanism, whereas others maintain that their co-existence is coincidental. Methods. We compared clinical and pathological features of 29 patients meeting criteria for both celiac disease and eosinophilic esophagitis to 26 celiac disease and 26 eosinophilic esophagitis controls to determine whether any distinguished study patients from controls. Results. Eight (28%) study patients presented with symptoms of both celiac disease and eosinophilic esophagitis, whereas 14 (48%) had celiac disease symptoms only and 5 had (17%) esophageal symptoms only. Study patients had similar autoimmune and atopic conditions seen in both control groups. Histological severity of disease, including Marsh II-III duodenal histology (study specimens: 87%; controls: 89%), mean peak esophageal eosinophil counts (study specimens: 55/400x field; controls: 80/400X field, P =.1), and presence of eosinophil microabscesses, scale crust, and subepithelial fibrosis were also similar to controls. Gluten-free diet resolved celiac disease-related symptoms (19 of 20, 95%) and histology (10 of 12, 83%), but not esophageal symptoms or eosinophilia in most study patients. Conclusion. Patients with concomitant celiac disease and eosinophilic esophagitis lack distinguishing features compared to controls with celiac disease or eosinophilic esophagitis alone. The occurrence of both disorders is likely coincidental in most cases. [ABSTRACT FROM AUTHOR]

Skull lesions in pediatric population are common findings on imaging and sometimes with heterogeneous manifestations, constituting a diagnostic challenge. Some lesions can be misinterpreted for their aggressiveness, as with larger lesions eroding cortical bone, containing soft tissue components, leading to excessive and, in some cases, invasive inappropriate etiological investigation. In this review, we present multiple several conditions that may present as skull lesions or pseudolesions, organized by groups (anatomic variants, congenital and development disorders, traumatic injuries, vascular issues, infectious conditions, and tumoral processes). Anatomic variants are common imaging findings that must be recognized by the neuroradiologist. Congenital malformations are rare conditions, such as aplasia cutis congenita and sinus pericranii, usually seen at earlier ages, the majority of which are benign findings. In case of trauma, cephalohematoma, growing skull fractures, and posttraumatic lytic lesions should be considered. Osteomyelitis tends to be locally aggressive and may mimic malignancy, in which cases, the clinical history can be the key to diagnosis. Vascular (sickle cell disease) and tumoral (aneurismal bone cyst, eosinophilic granuloma, metastases) lesions are relatively rare lesions but should be considered in the differential diagnosis, in the presence of certain imaging findings. The main difficulty is the differentiation between the benign and malignant nature; therefore, the main objective of this pictorial essay is to review the main skull lytic lesions found in pediatric age, describing the main findings in different imaging modalities (CT and MRI), allowing the neuroradiologist greater confidence in establishing the differential diagnosis, through a systematic and simple characterization of the lesions. [ABSTRACT FROM AUTHOR]

Background: Spinal eosinophilic granulomas (EG) are rare tumors, mostly reported in the pediatric age group. They constitute <1% of primary bone neoplasms, and cervical spine involvement is uncommon. Case Description: A 20-year-old male presented with neck pain for a 4-month duration. Six years previously, he had received six cycles of vinblastine for biopsy-proven histiocytosis of an axillary lymph node; this resulted in incomplete remission. Present magnetic resonance/computed tomography (CT) imaging revealed a lytic C2 body lesion with atlantoaxial instability. When the CT-guided biopsy was suggestive of EG, he was managed with definitive surgery and adjuvant radiotherapy. Conclusion: Cervical spine EG is rare in adults. CT-guided biopsy should confirm the diagnosis and should be followed by definitive surgery and adjuvant radiotherapy. [ABSTRACT FROM AUTHOR]

This article discusses a case of ulcerative shell lesions in a diamond-backed terrapin. The terrapin presented with scute sloughing and cystic ulcerative pitting lesions on the carapace and plastron. The lesions were found to be caused by a fungal infection with Emydomyces testavorans, a newly described cause of ulcerative shell lesions in aquatic turtles. The article highlights the importance of thorough examination and testing for fungal hyphae in samples from ulcerative shell lesions in aquatic turtles. [Extracted from the article]

This article discusses the delayed occurrence of foreign body reactions caused by poly-L-lactic acid (PLLA) fillers, which are commonly used for tissue augmentation and cosmetic purposes. The article presents a case study of a 52-year-old woman who developed granuloma formation over 100 months after receiving PLLA injections in the nasolabial fold. The article emphasizes the importance of healthcare providers recognizing the potential adverse effects of PLLA fillers and informing patients about these risks. It also highlights the effectiveness of intralesional steroid therapy in managing complications associated with PLLA injections. [Extracted from the article]

This article discusses the use of dupilumab, a monoclonal antibody, in the treatment of eosinophilic esophagitis (EoE). The study aimed to determine if dupilumab could improve the clinical and histologic features of EoE before 12 weeks of treatment. The researchers conducted a retrospective study on 79 patients and found that dupilumab induced histologic remission and clinical benefit even before 12 weeks of treatment. There were no significant differences in outcomes between patients on dupilumab for different durations. Further research is needed to determine the appropriate timing for repeat evaluations. [Extracted from the article]

A 44-year-old male presented with a swelling on the back of his skull and occasional mild headaches. After examination and neuroimaging, it was determined that the swelling was caused by intra-diploic arachnoid granulations, which are benign cystic lesions filled with cerebrospinal fluid. These cysts are often asymptomatic or may cause cosmetic disfigurement. MRI is the preferred imaging method to diagnose these cysts and rule out other conditions. Treatment may be necessary for symptomatic cysts to relieve pressure on surrounding structures. The patient provided consent for the publication of the case. [Extracted from the article]

Peripheral Giant Cell Granuloma (PGCG) is the most common benign and reactive hyperplastic giant cell lesion of the oral cavity originating either from the periodontal ligament or the periosteum of the adjacent tooth. The lesion has high recurrence rate, fast growing and sometimes cortical plates of the adjoining interdental bones are involved. Proper diagnosis is essential to differentiate it from other giant cell lesions of the oral cavity which is based on clinical, Dental implants are a popular option for tooth replacement due to their biocompatibility, strength, and durability. However, biocorrosion and the release of titanium particles from these implants have raised concerns, as they may contribute to peri-implantitis, a common inflammatory disease. Studies show that peri-implantitis sites exhibit more particles than healthy sites, with these particles found around implants and within epithelial cells, connective tissue, macrophages, and bone. Bio-corrosion, a complex process leading to implant failure, releases metallic particles into surrounding tissues, causing inflammation and tissue damage. Peri-implantitis, a bacterial infection, affects tissues around the implant, resulting in bone loss and potential implant failure. Factors influencing these complications include implant design, material properties, patient radiological and histopathological findings. Surgical excision along with curettage and peripheral osteotomy is the choice of treatment to prevent recurrence. The present paper reports a case of PGCG in the maxillary anterior region of an 8-year-old male child along with its diagnosis and management. [ABSTRACT FROM AUTHOR]

Sublingual traumatic ulceration is a rare inflammatory disorder characterized by benign, ulcerative, and granulomatous processes and caused by repetitive trauma from mandibular anterior incisors to the mucosa of the ventral surface of the tongue. Historically known as the Riga-Fede disease, sublingual ulceration is associated with natal and neonatal teeth in newborns and infants. Even cases have been reported of Riga-Fede disease associated with the eruption of mandibular primary incisors. Commonly, the treatment for Riga-Fede disease is the smoothening of incisal edges or the extraction of offending teeth. If this disorder is not diagnosed early and proper treatment is not provided, it may result in dehydration, nutritional deficiency, and deformity of the tongue. Here, we present a case of sublingual traumatic ulceration in a nine-year-old child, which is a rare occurrence. As the associated teeth in our case were permanent mandibular incisors, we opted for useful instructions to avoid repetitive trauma and medicinal treatment to resolve the lesion rather than extraction of teeth. We opted for topical corticosteroids with multivitamin supplements, which proved effective, and we achieved a positive outcome with complete resolution of the lesion following treatment., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sune et al.)

This case report highlights the understanding of the swelling feature of the right knee in a young adult and gives an overview of bone tumors. We are presenting a case of right knee swelling in a 13-year-old boy who was anxious before the investigations. Additionally, this report provides an approach for an accurate diagnosis of swelling. It highlights the approach to bone swelling and provides an overview of how to classify bone tumors. With the help of advanced technology such as magnetic resonance imaging (MRI), it gives detailed information about the nature of bone tumors, especially in the case of sessile osteochondroma. This case report also gives us information about the classification of bone tumors and their progression and guides us toward management with the help of an MRI., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Saifi et al.)

This article, published in the journal Endoscopy, examines the clinical presentation and endoscopic-histological features of patients with eosinophilic esophagitis (EoE) who were diagnosed with food impaction (FI) compared to those without FI (NFI). The study found that patients with FI had a less frequent occurrence of gastroesophageal reflux-like symptoms before EoE diagnosis compared to NFI patients. Additionally, FI patients had a higher EREFS score, indicating a more severe disease presentation, and a higher eosinophilic peak. The findings suggest that EoE patients with FI may have a less symptomatic disease course before diagnosis, potentially leading to a delay in diagnosis. [Extracted from the article]