Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Dig Endosc. 2014 May;26(3):337-43. doi: 10.1111/den.12150. Epub 2013 Jul 29.
We recently encountered patients with localized esophageal eosinophilia in a small area of the esophagus. However, this condition remains to be described in detail, and its clinical significance has not been established. We investigated the clinical, endoscopic and histological features of localized esophageal eosinophilia in comparison with diffuse esophageal eosinophilia.
We investigated 10 patients with localized esophageal eosinophilia, and compared them with 23 who had diffuse esophageal eosinophilia. Whether esophageal eosinophilia was localized or diffuse was determined on the basis of endoscopic findings. Localized esophageal eosinophilia was defined endoscopically as a focal area of esophageal eosinophilia, whereas diffuse esophageal eosinophilia was defined as a widespread area of esophageal eosinophilia involving more than one of three locations: the upper, middle and lower esophagus. Histological esophageal eosinophilia in the mucosa showing endoscopic abnormality was confirmed by biopsy with a peak of ≥ 15 eosinophils/high-power field.
There were no significant differences in age, gender distribution, allergic conditions or peripheral eosinophilia between the two groups. In all cases but one, localized esophageal eosinophilia was observed in a small area above the esophagogastric junction. Esophageal symptoms such as dysphagia, heartburn or chest pain were present in 20% of the localized group and in 65% of the diffuse group, the difference being statistically significant (P<0.05). The maximum amounts of eosinophils infiltrating the esophageal mucosa did not differ between the groups.
Esophageal eosinophilia can be localized in a small area, especially above the esophagogastric junction. Gastric acid reflux or contact may influence this condition in addition to its allergic pathogenesis.
我们最近在食管的一小部分区域遇到了局部性食管嗜酸性粒细胞增多症患者。然而，这种情况仍需要详细描述，其临床意义尚未确定。我们研究了局部性食管嗜酸性粒细胞增多症与弥漫性食管嗜酸性粒细胞增多症的临床、内镜和组织学特征。
我们研究了 10 例局部性食管嗜酸性粒细胞增多症患者，并将其与 23 例弥漫性食管嗜酸性粒细胞增多症患者进行了比较。根据内镜检查结果确定食管嗜酸性粒细胞增多是局部性还是弥漫性。内镜下局部性食管嗜酸性粒细胞增多定义为食管嗜酸性粒细胞增多的局灶性区域，而弥漫性食管嗜酸性粒细胞增多则定义为食管上、中、下三个部位之一以上的广泛区域累及食管嗜酸性粒细胞增多。在显示内镜异常的黏膜中，通过活检证实组织学上的食管嗜酸性粒细胞增多，其峰值≥15 个嗜酸性粒细胞/高倍视野。
两组在年龄、性别分布、过敏情况或外周嗜酸性粒细胞增多方面无显著差异。除 1 例外，所有病例的局部性食管嗜酸性粒细胞增多均发生在食管胃交界处上方的小区域。局部性组 20%的患者存在吞咽困难、烧心或胸痛等食管症状，而弥漫性组 65%的患者存在这些症状，差异具有统计学意义（P<0.05）。两组食管黏膜浸润的嗜酸性粒细胞最大数量无差异。
食管嗜酸性粒细胞增多可局限于一小部分区域，特别是食管胃交界处上方。胃酸反流或接触除了其过敏发病机制外，可能会影响这种情况。
