Division of Pathological Anatomy, AOUS, Siena, Italy.
Rev Esp Enferm Dig. 2010 Jan;102(1):15-9. doi: 10.4321/s1130-01082010000100003.
Eosinophilic esophagitis is an esophageal disorder characterized by esophageal and/or upper gastrointestinal tract symptoms, and by dense esophageal eosinophilia associated with a normal gastric and duodenal mucosa. Prevalently reported in children, eosinophilic esophagitis has recently been reported with increased frequency also in adults.
The purpose of this study was to report our experience with eosinophilic esophagitis in Italy, since there are only very few series of such patients in our country.
We retrospectively reviewed the histological data of consecutive patients with a diagnosis of esophagitis or reflux disease in the period September 2004-September 2008. Eosinophils were counted where they appeared most numerous in the biopsy, with a cutoff > 15 eosinophils in more than one high-power field as diagnostic of eosinophilic esophagitis. Patients were excluded if gastric or duodenal biopsies showed a prominent eosinophilic infiltrate.
Twenty two patients (14 adults, 8 children, age range 2-59 years) were identified according to the above criteria. The average eosinophil count was 86/ high-power field (range 31-150), associated with other pathologic features (eosinophilic microabscesses eosinophil degranulation, basal zone hyperplasia, papillary elongation). The main clinical complaints were dysphagia, food impaction, and heartburn, and endoscopic findings consisted of mucosal thickening and inelasticity, longitudinal shearing, rings, and white specks, without difference between adults and children for both clinical and endoscopic variables.
Eosinophilic esophagitis is not rare in Italy, and displays clinical, endoscopic, and pathologic features similar to those described in other countries.
嗜酸性食管炎是一种食管疾病，其特征为食管和/或上消化道症状，以及与正常胃和十二指肠黏膜相关的密集性食管嗜酸性粒细胞增多。嗜酸性食管炎在儿童中更为常见，近年来在成人中也有越来越多的报道。
本研究旨在报告意大利嗜酸性食管炎的经验，因为在我国仅有极少数此类患者的系列报道。
我们回顾性分析了 2004 年 9 月至 2008 年 9 月期间连续诊断为食管炎或反流性疾病患者的组织学数据。在活检中计数嗜酸性粒细胞数量最多的部位，超过一个高倍视野中嗜酸性粒细胞计数>15 个作为嗜酸性食管炎的诊断标准。如果胃或十二指肠活检显示明显的嗜酸性粒细胞浸润，则排除患者。
根据上述标准，共确定了 22 例患者（14 例成人，8 例儿童，年龄 2-59 岁）。平均嗜酸性粒细胞计数为 86/高倍视野（范围 31-150），伴有其他病理特征（嗜酸性微脓肿、嗜酸性粒细胞脱颗粒、基底膜增生、乳头伸长）。主要临床症状为吞咽困难、食物嵌塞和烧心，内镜下表现为黏膜增厚和无弹性、纵向撕裂、环状和白色斑点，成人和儿童在临床和内镜变量方面均无差异。
嗜酸性食管炎在意大利并不罕见，其临床表现、内镜和病理特征与其他国家描述的相似。
