title: A Japanese case of eosinophilic esophagitis.
abstract: Eosinophilic esophagitis (EE) is a rarely diagnosed condition involving eosinophilic infiltration of the esophageal mucosa. Here we present a case of EE in a 69-year-old Japanese man, who presented with abdominal pain, appetite loss, and a history of bronchial asthma. Laboratory findings included peripheral eosinophilia and an increased serum immunoglobulin E level. Computed tomography showed diffuse severe thickening of the esophageal wall, and a barium esophagogram revealed a small caliber of the middle and lower portion of the esophagus, without normal peristaltic contractions. Endoscopy of the esophagus showed a pale mucosa, with adherent whitish exudates resembling fungal infection, and prominent ring-like contractions. Histologic examination of a biopsy specimen revealed marked eosinophil infiltration into the esophageal mucosa. Endoscopic ultrasonography (EUS) demonstrated marked circumferential thickening of the esophageal submucosal layer, and an esophageal manometry study showed a high percentage of ineffective esophageal peristalsis and high-amplitude esophageal body contractions. EUS findings showed no change even after oral corticosteroid therapy, although the histological findings were improved. This is thought to be the first documented Japanese case of EE. EE should be considered in the differential diagnosis in cases of esophageal motility disturbance, even if the patients do not complain of dysphagia.
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Furuta
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Adachi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kowari
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mishima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imaoka
authors.forename: Chikara
authors.initials: C
authors.lastname: Kadota
authors.forename: Kenji
authors.initials: K
authors.lastname: Koshino
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyake
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kadowaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Furuta
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kazumori
authors.forename: Shuichi
authors.initials: S
authors.lastname: Sato
authors.forename: Shunji
authors.initials: S
authors.lastname: Ishihara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Amano
authors.forename: Masaaki
authors.initials: M
authors.lastname: Honda
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D004802:Eosinophilia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000276:immunology; D004941:Esophagitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000276:immunology; D004947:Esophagus / Q000000981:diagnostic imaging; D006801:Humans; D007564:Japan; D008297:Male; D011859:Radiography; D014463:Ultrasonography