Endoscopic, bioptic, and manometric findings in eosinophilic esophagitis before and after steroid therapy: a case series.
OBJECTIVE
Eosinophilic esophagitis can be associated with a wide range of endoscopic patterns. The aim of the present case series report is to describe and classify endoscopic appearances before and after corticoid therapy in relation to histopathology and manometry.


METHODS
In 30 patients (m : f, 27 : 3; mean age 36.2 years) with eosinophilic esophagitis, endoscopic findings were prospectively classified according to luminal diameter and mucosal pattern. Manometric and bioptic histopathologic findings were also recorded. Endoscopy was repeated following a 3-month course of steroid therapy.


RESULTS
In total, 20 % of patients showed a concentric esophageal stricture, and in 57 % simultaneous contraction rings were visible. Mucosal alterations consisted of granular mucosa (20 %), longitudinal furrows (33 %) and transversal undulations (3 %). Lower esophageal sphincter dysfunction and distal esophageal dysfunctional manometry were seen in 73 % and 57 % of cases, respectively. Following steroids, the esophagus showed a normal caliber in 97 % of patients, and 63 % of patients had normal mucosa.


CONCLUSIONS
The most frequent findings were narrowing of the esophageal lumen, which returned to normal following steroid treatment to a larger extent than mucosal alterations.
Lucendo
A J
AJ
Department of Gastroenterology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain. alucendo@vodafone.es
Pascual-Turrión
J M
JM
Navarro
M
M
Comas
C
C
Castillo
P
P
Letrán
A
A
Caballero
M T
MT
Larrauri
J
J
D000287:Administration, Topical; D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage*; D004804:Eosinophils; D004941:Esophagitis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004945:Esophagoscopy; D005260:Female; D000068298:Fluticasone; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008365:Manometry; D011446:Prospective Studies
D000730:Androstadienes; D005938:Glucocorticoids; D000068298:Fluticasone