Clinical Significance of Incidentally Detected Eosinophilic Esophagitis with Pathologic Review

Youn Mu Jung, Hye Seung Lee, Dong Ho Lee, You Jeong Jeong, Tae Hyuck Choi, Sang Hyub Lee, Young Soo Park, Jin-Hyok Hwang, Jin-Wook Kim, Sook-Hyang Jeong, Nayoung Kim
2010 Korean Journal of Gastroenterology  
Background/Aims: Eosinophilic esophagitis (EE) is a chronic inflammatory disorder characterized by abnormal dense eosinophilic infiltration of esophageal mucosa and results in dysphasia and food impaction. EE is being increasingly recognized in adults. The prevalence is largely unknown. This study was performed to evaluate the detection rate of EE diagnosed based on pathologic criteria and to define the clinical characteristics of EE in Korea. Methods: We reviewed biopsy specimen of the 1,609
more » ... tients who underwent esophageal biopsy from January 2006 till August 2008. The presence of more than 20 eosinophils per high power field in biopsy specimens was considered cases of EE. Clinical information and endoscopic findings were obtained. Results: 7 (0.4%) patients were diagnosed as EE based on pathologic criteria retrospectively. Clinical symptoms were epigastric pain (43%), regurgitation (29%), dyspepsia (14%), and no symptom (14%). Endoscopic findings were whitish exudates or granules (57%), esophageal polyp (29%), and hyperemic change (14%). Two patients received treatment. One patient with bronchial asthma improved after treatment with inhaled corticosteroid, and one patient improved after 8 week proton pump inhibitor therapy. Conclusions: Eosinophilic esophagitis was found in 0.4% of the total esophageal biopsied cases. Our results suggest that Korean patients with eosinophilic esophagitis showed symptoms mimicking gastroesophageal reflux disease and atypical endoscopic findings. Therefore, regardless of the gross appearance of the mucosa, meticulous diagnostic approaches are needed for patients with swallowing difficulty and lack of response to proton pump inhibitor. (Korean J Gastroenterol 2010;55:162-168) Key Word: Eosinophilic esophagitis 정연무 외 10인. 식도 조직 검사상 우연히 발견된 호산구 식도염의 임상적 의의 163
doi:10.4166/kjg.2010.55.3.162 pmid:20357526 fatcat:pbsmrudd6zgann4zay2um467ju