[Clinical significance of incidentally detected eosinophilic esophagitis with pathologic review].
OBJECTIVE
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 patients 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.
Jung
Youn Mu
YM
Department of Internal Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, Korea.
Lee
Hye Seung
HS
Lee
Dong Ho
DH
Jeong
You Jeong
YJ
Choi
Tae Hyuck
TH
Lee
Sang Hyub
SH
Park
Young Soo
YS
Hwang
Jin-Hyok
JH
Kim
Jin-Wook
JW
Jeong
Sook-Hyang
SH
Kim
Nayoung
N
D000328:Adult; D000368:Aged; D001706:Biopsy; D004415:Dyspepsia / Q000209:etiology; D004802:Eosinophilia / Q000453:epidemiology / Q000473:pathology*; D004941:Esophagitis / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D057045:Laryngopharyngeal Reflux / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies