Some doctors count the number of eosinophils when they biopsy and other docs dont count. Whats the significance of the cell counts?
The significance of the number of eosinophils in a biopsy is best known for biopsies from the esophagus. The esophagus normally has very few, if any, eosinophils in the epithelium, the part of the wall that lines the inner surface of the esophagus. Biopsies of patients who have gastroesophageal reflux disease (GERD) may contain a few eosinophils in the epithelium, but generally intraepithelial eosinophils are not numerous in those biopsies. The number of eosinophils can be used to distinguish patients who have GERD, or at least patients who will respond to anti-GERD medications, from those who have eosinophilic esophagitis (EE), who are very unlikely to find relief from symptoms using anti-GERD medications, and who generally require other sorts of interventions. The exact number that can be used to identify EE is not universally accepted, but most laboratories use at least 15 eosinophils in a high power field, and many require 20-25 eosinophils in a high power field to identify EE. A h
