Mackenzie S H, Go M, Chadwick B, Thomas K, Fang J, Kuwada S, Lamphier S, Hilden K, Peterson K
Division of Gastroenterology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA.
Aliment Pharmacol Ther. 2008 Nov 1;28(9):1140-6. doi: 10.1111/j.1365-2036.2008.03795.x. Epub 2008 Jul 4.
Eosinophilic oesophagitis (EoO) may be a common finding in adults presenting with dysphagia.
To identify the risk factors and prevalence of EoO in an adult population with dysphagia.
All patients with dysphagia referred for an upper endoscopy (EGD) were asked to participate. Patients completed a detailed questionnaire followed by EGD with four quadrant biopsies in the distal and mid-oesophagus. Primary endpoint was the prevalence of EoO; secondary endpoints included age, gender, asthma, food allergies, gastro-oesophageal reflux disease/dysphagia score and endoscopic findings.
Two hundred and sixty-one patients enrolled between December 2005 and January 2007. Thirty-one patients (12%) met pathological criteria for EoO. There was no difference in EoO prevalence within each gender. Mean age of EoO patients was 42 +/- 15 vs. 61 +/- 15 for non-EoO patients (P < 0.001). EoO was diagnosed in 35% of patients <50 years of age. EoO was present in 22% of asthmatics vs. 9% non-asthmatics (P < 0.01). EoO was present in 36.8% of patients with self-reported food allergies vs. 9.3% those without allergy (P < 0.001). A 13/31(42%) of EoO patients did not have the classic EGD findings (rings +/- furrows) and would have been missed without oesophageal biopsies.
Eosinophilic oesophagitis was diagnosed in 12% of the patients presenting with dysphagia with relative risk of 9.5 if age <50 years. Oesophageal biopsies are warranted in patients presenting with dysphagia especially in the younger population. Patients may not present with classic endoscopic findings and EoO can be missed without biopsies.
嗜酸性粒细胞性食管炎（EoO）可能是成人吞咽困难患者的常见表现。
确定成人吞咽困难患者中EoO的危险因素和患病率。
所有因吞咽困难而接受上消化道内镜检查（EGD）的患者均被邀请参与。患者完成一份详细问卷，随后进行EGD检查，并在食管远端和中段取四个象限的活检组织。主要终点是EoO的患病率；次要终点包括年龄、性别、哮喘、食物过敏、胃食管反流病/吞咽困难评分和内镜检查结果。
2005年12月至2007年1月期间共有261例患者入组。31例患者（12%）符合EoO的病理标准。各性别间EoO患病率无差异。EoO患者的平均年龄为42±15岁，非EoO患者为61±15岁（P<0.001）。35%年龄<50岁的患者被诊断为EoO。22%的哮喘患者存在EoO，而非哮喘患者为9%（P<0.01）。36.8%自述有食物过敏的患者存在EoO，无过敏者为9.3%（P<0.001）。13/31（42%）的EoO患者没有典型的EGD表现（环+/-皱襞），若不进行食管活检则会漏诊。
在因吞咽困难就诊的患者中，12%被诊断为嗜酸性粒细胞性食管炎，年龄<50岁时相对风险为9.5。有吞咽困难的患者，尤其是年轻患者，有必要进行食管活检。患者可能没有典型的内镜表现，若不进行活检可能会漏诊EoO。
