Vitellas K M, Bennett W F, Bova J G, Johnston J C, Caldwell J H, Mayle J E
Department of Radiology, Ohio State University Hospitals, Columbus 43210.
Radiology. 1993 Mar;186(3):789-93. doi: 10.1148/radiology.186.3.8430189.
A retrospective review was performed of 13 patients with the diagnosis of idiopathic eosinophilic esophagitis (IEE) occurring alone or in conjunction with idiopathic eosinophilic gastroenteritis (IEG) to identify clinical, radiographic, endoscopic, manometric, and therapeutic similarities. All patients presented with esophageal symptoms, predominantly dysphagia. An allergic disorder was present in 10 (77%) patients, and peripheral eosinophilia was present in 12 (92%) patients. Clinical investigation disclosed esophageal strictures in 10 patients, motility disorders in three, ulcerations in two, a cervical web in one, and a mucosal ring in one as the cause of esophageal symptoms. A proximal esophageal stricture was the single most common esophageal abnormality demonstrated. IEE should be included in the differential diagnosis of dysphagia and should be suggested in a patient with an allergic disorder, peripheral eosinophilia, and concurrent abdominal symptoms, especially in conjunction with IEG. Prompt diagnosis is extremely important since treatment with steroids produces rapid clinical remission in most patients.
对13例单独诊断为特发性嗜酸性食管炎（IEE）或合并特发性嗜酸性胃肠炎（IEG）的患者进行回顾性研究，以确定其临床、影像学、内镜、测压及治疗方面的相似之处。所有患者均有食管症状，主要为吞咽困难。10例（77%）患者存在过敏性疾病，12例（92%）患者存在外周血嗜酸性粒细胞增多。临床检查发现，10例患者存在食管狭窄，3例存在动力障碍，2例存在溃疡，1例存在颈蹼，1例存在黏膜环，这些均为食管症状的病因。近端食管狭窄是最常见的食管异常表现。IEE应列入吞咽困难的鉴别诊断中，对于患有过敏性疾病、外周血嗜酸性粒细胞增多且伴有腹部症状的患者，尤其是合并IEG的患者，应考虑该病。由于大多数患者使用类固醇治疗后临床症状能迅速缓解，因此及时诊断极为重要。
