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如何诊治淋巴细胞性食管炎

How to Approach Lymphocytic Esophagitis.

作者信息

Nguyen Anh D, Dunbar Kerry B

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, 75231, USA.

Esophageal Diseases Center, Division of Gastroenterology and Hepatology, Department of Medicine, Dallas VA Medical Center and the University of Texas Southwestern Medical Center, GI Lab-CA 111-B1, Dallas VAMC, 4500 South Lancaster Road, Dallas, TX, 75231, USA.

出版信息

Curr Gastroenterol Rep. 2017 Jun;19(6):24. doi: 10.1007/s11894-017-0564-y.

Abstract

PURPOSE OF REVIEW

Lymphocytic esophagitis (LE) is an unusual esophageal condition defined by an increased number of lymphocytes in the esophageal epithelium. With few published studies of LE available, it is unclear whether LE is a truly distinct clinical entity or a histological manifestation of other known gastrointestinal disorders. This review summarizes recent studies of lymphocytic esophagitis.

RECENT FINDINGS

Studies have suggested that LE may be related to eosinophilic esophagitis (EoE) or a manifestation of gastroesophageal reflux disease (GERD). There is an association between LE and Crohn's disease in children, but not in adults. Patients with LE frequently report symptoms of dysphagia and GERD. Treatment options for LE are limited and involve symptom management similar to treatment of EoE or GERD, including proton pump inhibitors (PPI), swallowed topical steroids, and endoscopic dilation. With no formal definition and a variety of clinical presentations and endoscopic findings, diagnosis and management of symptomatic LE patients is challenging for clinicians.

摘要

综述目的

淋巴细胞性食管炎(LE)是一种不常见的食管疾病,其定义为食管上皮内淋巴细胞数量增多。由于关于LE的已发表研究较少,目前尚不清楚LE是一种真正独特的临床实体,还是其他已知胃肠道疾病的组织学表现。本综述总结了淋巴细胞性食管炎的近期研究。

最新发现

研究表明,LE可能与嗜酸性粒细胞性食管炎(EoE)有关,或者是胃食管反流病(GERD)的一种表现。儿童LE与克罗恩病之间存在关联,但成人中不存在。LE患者经常报告吞咽困难和GERD症状。LE的治疗选择有限,包括与EoE或GERD治疗类似的症状管理,如质子泵抑制剂(PPI)、吞咽局部类固醇和内镜扩张。由于没有正式定义,且存在多种临床表现和内镜检查结果,有症状的LE患者的诊断和管理对临床医生来说具有挑战性。

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