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[嗜酸性粒细胞性食管炎:儿科人群发病率上升]

[Eosinophilic esophagitis: increasing incidence in paediatric population].

作者信息

Braga-Tavares Hugo, Teles Andreia, Nogueira Rosete, Cardoso Rodrigues Fernando, Costa Cristina

机构信息

Serviço de Pediatria. Centro Hospitalar Vila Nova de Gaia/Espinho. Vila Nova de Gaia.

出版信息

Acta Med Port. 2009 Sep-Oct;22(5):579-88. Epub 2009 Oct 22.

Abstract

INTRODUCTION

Eosinophilic Esophagitis has been increasingly diagnosed and results from a chronic esophagic inflammation with eosinophilic infiltrate.

MATERIAL AND METHODS

Evaluation of the diagnosed paediatric cases in our centre between 2004 and 2008 and revision of current literature on this subject.

RESULTS

Four caucasian boys, aged eight to fifteen years old, were diagnosed with Eosinophilic Esophagitis. They presented with disphagia and food impaction and endoscopic findings included multiple concentric rings (pseudo-trachea pattern) and friable mucosa. All of them had mucosal eosinophil counts higher than 20 eosinophils/high-powered field and were given corticosteroids, either topic or systemic (one case) with therapeutic success.

DISCUSSION

The diagnosis of Eosinophilic Esophagitis must be considered in presence of disphagia, food impaction or gastroesophageal reflux symptoms refractory to treatment. Endoscopic evaluation may be normal and the diagnosis is based on histological findings, making biopsy mandatory whenever clinically suspected. The increasing incidence of the last years associated with the high recurrence rate will lead to future prevalence increased both in child and adulthood.

摘要

引言

嗜酸性粒细胞性食管炎的诊断日益增多,它是由伴有嗜酸性粒细胞浸润的慢性食管炎症引起的。

材料与方法

对我们中心2004年至2008年间诊断的儿科病例进行评估,并查阅有关该主题的当前文献。

结果

4名年龄在8至15岁的白人男孩被诊断为嗜酸性粒细胞性食管炎。他们表现为吞咽困难和食物嵌塞,内镜检查结果包括多个同心圆(假气管模式)和易碎黏膜。他们所有人的黏膜嗜酸性粒细胞计数均高于20个嗜酸性粒细胞/高倍视野,并接受了局部或全身用皮质类固醇治疗(1例),治疗取得成功。

讨论

当出现吞咽困难、食物嵌塞或治疗难治的胃食管反流症状时,必须考虑嗜酸性粒细胞性食管炎的诊断。内镜评估可能正常,诊断基于组织学发现,因此每当临床怀疑时都必须进行活检。近年来发病率的增加以及高复发率将导致儿童和成人未来患病率上升。

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