Owaki Takashi, Sato Hiroki, Horigome Ryoko, Hashimoto Satoru, Honma Terasu, Terai Shuji
Department of Gastroenterology, Saiseikai Niigata Daini Hospital, Niigata, Japan.
Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, 757-1, Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan.
Clin J Gastroenterol. 2019 Oct;12(5):420-423. doi: 10.1007/s12328-019-00960-4. Epub 2019 Mar 8.
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder in the esophagus characterized by symptoms related to esophageal dysfunction and eosinophil-predominant inflammation. EoE and Gastro Esophageal Reflux Disease (GERD) are known not to be mutually exclusive and share a complex relationship. Proton pump inhibitors (PPIs), which are generally used in the treatment of GERD, could be used to treat esophageal eosinophilia in suspected EoE. We report a rare case of EoE after total gastrectomy that responded to PPIs. Our case indicates that the onset of EoE does not necessarily require an acid reflux-induced antigen-mediated drive, and the action of PPIs in patients with active EoE is unrelated to gastric acid suppression.
嗜酸性食管炎(EoE)是一种慢性免疫介导的食管疾病,其特征为与食管功能障碍相关的症状以及以嗜酸性粒细胞为主的炎症。已知EoE与胃食管反流病(GERD)并非相互排斥,而是存在复杂的关系。通常用于治疗GERD的质子泵抑制剂(PPI)可用于治疗疑似EoE患者的食管嗜酸性粒细胞增多症。我们报告了一例全胃切除术后发生EoE且对PPI有反应的罕见病例。我们的病例表明,EoE的发病不一定需要酸反流诱导的抗原介导驱动,PPI对活动性EoE患者的作用与胃酸抑制无关。