Seasonal variation in detection of oesophageal eosinophilia and eosinophilic oesophagitis.

Journal Article (Journal Article)


Seasonal variation has been reported in diagnosis of eosinophilic oesophagitis (EoE), but results are not consistent across studies and there are no national-level data in the USA.


To determine if there is seasonal variation in diagnosis of oesophageal eosinophilia and EoE in the USA, while accounting for factors such as climate zone and geographic variation.


This was a cross-sectional study using a USA national pathology database. Patients with oesophageal eosinophilia (≥15 eosinophils per high-power field) comprised the primary case definition and were compared to those with normal oesophageal biopsies. We calculated the crude and adjusted odds of oesophageal eosinophilia by season, as well as by day of the year. Sensitivity analyses were performed using more restrictive case definitions of EoE, and after stratification by climate zone.


Exactly, 14 524 cases with oesophageal eosinophilia and 90 459 normal controls were analysed. The adjusted odds of oesophageal eosinophilia were higher in the late spring and summer months, with the highest odds in July (aOR: 1.13; 95% CI: 1.03-1.24). These findings persisted with increasing levels of oesophageal eosinophilia, as well as across EoE case definitions. Seasonal variation was strongest in temperate and cold climates, and peak diagnosis varied by climate zone.


There is a mild but consistent seasonal variation in the diagnosis of oesophageal eosinophilia and EoE, with cases more frequently diagnosed during summer months. These findings take into account climate and geographic differences, suggesting that aeroallergens may contribute to disease development or flare.

Full Text

Duke Authors

Cited Authors

  • Jensen, ET; Shah, ND; Hoffman, K; Sonnenberg, A; Genta, RM; Dellon, ES

Published Date

  • August 2015

Published In

Volume / Issue

  • 42 / 4

Start / End Page

  • 461 - 469

PubMed ID

  • 26059636

Pubmed Central ID

  • PMC4506219

Electronic International Standard Serial Number (EISSN)

  • 1365-2036

International Standard Serial Number (ISSN)

  • 0269-2813

Digital Object Identifier (DOI)

  • 10.1111/apt.13273


  • eng