Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children?

Background: We observed an endoscopic abnormality in a group of children with histological esophagitis. We termed this finding “vertical lines in esophageal mucosa” (VLEM). We examined the relationship between the presence of VLEM and significant histologic changes in esophageal mucosal biopsies. Me...

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Veröffentlicht in:Gastrointestinal endoscopy 1997-06, Vol.45 (6), p.485-489
Hauptverfasser: Gupta, Sandeep K., Fitzgerald, Joseph F., Chong, Sonny K.F., Croffie, Joseph M., Collins, Margaret H.
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container_end_page 489
container_issue 6
container_start_page 485
container_title Gastrointestinal endoscopy
container_volume 45
creator Gupta, Sandeep K.
Fitzgerald, Joseph F.
Chong, Sonny K.F.
Croffie, Joseph M.
Collins, Margaret H.
description Background: We observed an endoscopic abnormality in a group of children with histological esophagitis. We termed this finding “vertical lines in esophageal mucosa” (VLEM). We examined the relationship between the presence of VLEM and significant histologic changes in esophageal mucosal biopsies. Methods: Between January 1, 1992, and August 31, 1994, the senior author (JFF) performed 255 esophageal biopsies. The procedure reports, available endoscopic photographs, and histology reports were reviewed to establish the endoscopic and histologic appearance of the esophageal mucosa. Intraepithelial cells were counted in a blind review of 42 randomly selected biopsies. Results: The esophageal mucosa had a normal appearance on 160 endoscopic studies (Group 1) and VLEM were the only mucosal abnormalities in 41 endoscopies (Group 2). Histology was normal in 92 of 160 biopsies (57.5%) from Group 1, and 1 of 41 biopsies (2.4%) from Group 2. Most patients in Group 2 had eosinophilic esophagitis (34 of 41, 83%, specificity 0.85, sensitivity 0.5, p < 0.001) which was of moderate to severe intensity (31 of 34, 91.2%, specificity 0.88, sensitivity 0.73, p < 0.001). Conclusions: Histology usually demonstrated moderate to severe inflammation when VLEM were present. VLEM may be a highly specific endoscopic feature of esophagitis in children. (Gastrointest Endosc 1997;45:485-9.)
doi_str_mv 10.1016/S0016-5107(97)70178-0
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We termed this finding “vertical lines in esophageal mucosa” (VLEM). We examined the relationship between the presence of VLEM and significant histologic changes in esophageal mucosal biopsies. Methods: Between January 1, 1992, and August 31, 1994, the senior author (JFF) performed 255 esophageal biopsies. The procedure reports, available endoscopic photographs, and histology reports were reviewed to establish the endoscopic and histologic appearance of the esophageal mucosa. Intraepithelial cells were counted in a blind review of 42 randomly selected biopsies. Results: The esophageal mucosa had a normal appearance on 160 endoscopic studies (Group 1) and VLEM were the only mucosal abnormalities in 41 endoscopies (Group 2). Histology was normal in 92 of 160 biopsies (57.5%) from Group 1, and 1 of 41 biopsies (2.4%) from Group 2. Most patients in Group 2 had eosinophilic esophagitis (34 of 41, 83%, specificity 0.85, sensitivity 0.5, p &lt; 0.001) which was of moderate to severe intensity (31 of 34, 91.2%, specificity 0.88, sensitivity 0.73, p &lt; 0.001). Conclusions: Histology usually demonstrated moderate to severe inflammation when VLEM were present. VLEM may be a highly specific endoscopic feature of esophagitis in children. (Gastrointest Endosc 1997;45:485-9.)</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/S0016-5107(97)70178-0</identifier><identifier>PMID: 9199905</identifier><identifier>CODEN: GAENBQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Biological and medical sciences ; Biopsy ; Cell Count ; Child ; Child, Preschool ; Digestive system. 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Abdomen</topic><topic>Endoscopy</topic><topic>Endosonography</topic><topic>Esophagitis - diagnostic imaging</topic><topic>Esophagitis - pathology</topic><topic>Esophagoscopy - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intestinal Mucosa - diagnostic imaging</topic><topic>Intestinal Mucosa - pathology</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Observer Variation</topic><topic>Random Allocation</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gupta, Sandeep K.</creatorcontrib><creatorcontrib>Fitzgerald, Joseph F.</creatorcontrib><creatorcontrib>Chong, Sonny K.F.</creatorcontrib><creatorcontrib>Croffie, Joseph M.</creatorcontrib><creatorcontrib>Collins, Margaret H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gupta, Sandeep K.</au><au>Fitzgerald, Joseph F.</au><au>Chong, Sonny K.F.</au><au>Croffie, Joseph M.</au><au>Collins, Margaret H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children?</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>1997-06-01</date><risdate>1997</risdate><volume>45</volume><issue>6</issue><spage>485</spage><epage>489</epage><pages>485-489</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><coden>GAENBQ</coden><abstract>Background: We observed an endoscopic abnormality in a group of children with histological esophagitis. 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subjects Adolescent
Biological and medical sciences
Biopsy
Cell Count
Child
Child, Preschool
Digestive system. Abdomen
Endoscopy
Endosonography
Esophagitis - diagnostic imaging
Esophagitis - pathology
Esophagoscopy - methods
Female
Humans
Infant
Infant, Newborn
Intestinal Mucosa - diagnostic imaging
Intestinal Mucosa - pathology
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Observer Variation
Random Allocation
Retrospective Studies
Sensitivity and Specificity
title Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children?
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