Straumann A, Spichtin H P, Bernoulli R, Loosli J, Vögtlin J
FMH für Innere Medizin, Spez. Gastroenterologie, Römerstrasse 7, Olten.
Schweiz Med Wochenschr. 1994 Aug 20;124(33):1419-29.
In 10 patients presenting with acute recurrent dysphagia, seen over a 4-year period, idiopathic, eosinophilic esophagitis (IEE) was diagnosed. The diagnosis was confirmed histologically. Dysphagia of other causes or other diseases causing eosinophilic infiltration was ruled out. Endoscopy showed discrete white structures in the esophagus which were partly finely reticular or plaque-like in 9 of the 10 patients. Of these one had a web and another a mucosal ring. Peripheral eosinophilia and elevated IgE-levels were found in 70% of the cases. To date IEE has been thought to be a rare disorder. Emerging evidence suggests its prevalence has been underestimated. It may also be the most frequent form of eosinophilic gastroenteropathy. The flat, only endoscopically visible form may be more common than the proliferative type. With knowledge of the typical history and of the distinct endoscopic pattern, and with adequate diagnostic workup, the disease will be found more often in the future. Prompt diagnosis also avoids further diagnostic procedures and permits rapid remission through treatment with steroids and antihistamines.
在4年期间诊治的10例急性复发性吞咽困难患者中，诊断为特发性嗜酸性粒细胞性食管炎（IEE）。组织学检查确诊。排除了其他原因引起的吞咽困难或其他导致嗜酸性粒细胞浸润的疾病。内镜检查显示食管内有散在的白色结构，10例患者中有9例部分呈细网状或斑块状。其中1例有食管蹼，另1例有黏膜环。70%的病例发现外周血嗜酸性粒细胞增多和IgE水平升高。迄今为止，IEE一直被认为是一种罕见疾病。新出现的证据表明其患病率被低估了。它也可能是嗜酸性粒细胞性胃肠病最常见的形式。仅在内镜下可见的扁平型可能比增殖型更常见。了解典型病史和独特的内镜表现，并进行充分的诊断检查，未来会更频繁地发现这种疾病。及时诊断还可避免进一步的诊断程序，并通过使用类固醇和抗组胺药治疗实现快速缓解。
