Jung Youn Mu, Lee Hye Seung, Lee Dong Ho, Jeong You Jeong, Choi Tae Hyuck, Lee Sang Hyub, Park Young Soo, Hwang Jin-Hyok, Kim Jin-Wook, Jeong Sook-Hyang, Kim Nayoung
Department of Internal Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, Korea.
Korean J Gastroenterol. 2010 Mar;55(3):162-8. doi: 10.4166/kjg.2010.55.3.162.
BACKGROUND/AIMS: Eosinophilic esophagitis (EE) is a chronic inflammatory disorder characterized by abnormal dense eosinophilic infiltration of esophageal mucosa and results in dysphasia and food impaction. EE is being increasingly recognized in adults. The prevalence is largely unknown. This study was performed to evaluate the detection rate of EE diagnosed based on pathologic criteria and to define the clinical characteristics of EE in Korea.
We reviewed biopsy specimen of the 1,609 patients who underwent esophageal biopsy from January 2006 till August 2008. The presence of more than 20 eosinophils per high power field in biopsy specimens was considered cases of EE. Clinical information and endoscopic findings were obtained.
7 (0.4%) patients were diagnosed as EE based on pathologic criteria retrospectively. Clinical symptoms were epigastric pain (43%), regurgitation (29%), dyspepsia (14%), and no symptom (14%). Endoscopic findings were whitish exudates or granules (57%), esophageal polyp (29%), and hyperemic change (14%). Two patients received treatment. One patient with bronchial asthma improved after treatment with inhaled corticosteroid, and one patient improved after 8 week proton pump inhibitor therapy.
Eosinophilic esophagitis was found in 0.4% of the total esophageal biopsied cases. Our results suggest that Korean patients with eosinophilic esophagitis showed symptoms mimicking gastroesophageal reflux disease and atypical endoscopic findings. Therefore, regardless of the gross appearance of the mucosa, meticulous diagnostic approaches are needed for patients with swallowing difficulty and lack of response to proton pump inhibitor.
背景/目的：嗜酸性粒细胞性食管炎（EE）是一种慢性炎症性疾病，其特征为食管黏膜出现异常密集的嗜酸性粒细胞浸润，并导致吞咽困难和食物嵌塞。EE在成人中越来越受到关注。其患病率在很大程度上尚不清楚。本研究旨在评估基于病理标准诊断的EE的检出率，并确定韩国EE的临床特征。
我们回顾了2006年1月至2008年8月期间接受食管活检的1609例患者的活检标本。活检标本中每高倍视野嗜酸性粒细胞超过20个被视为EE病例。获取了临床信息和内镜检查结果。
回顾性分析发现，7例（0.4%）患者基于病理标准被诊断为EE。临床症状包括上腹部疼痛（43%）、反流（29%）、消化不良（14%）和无症状（14%）。内镜检查结果为白色渗出物或颗粒（57%）、食管息肉（29%）和充血改变（14%）。2例患者接受了治疗。1例支气管哮喘患者吸入糖皮质激素治疗后病情改善，1例患者接受8周质子泵抑制剂治疗后病情改善。
在所有食管活检病例中，嗜酸性粒细胞性食管炎的检出率为0.4%。我们的结果表明，韩国嗜酸性粒细胞性食管炎患者表现出类似胃食管反流病的症状和非典型内镜检查结果。因此，对于吞咽困难且对质子泵抑制剂治疗无反应的患者无论黏膜外观如何都需要细致的诊断方法。
