Clinical features of eosinophilic esophagitis: ten Japanese cases.
OBJECTIVE
We studied eosinophilic esophagitis (EE) to clarify the clinical and endoscopic features of a Japanese case series.


METHODS
Records of 10 patients diagnosed with EE at our hospital between May 2010 and December 2011 were examined for age, sex, symptoms, allergic disorder, endoscopic findings, and treatment received. Esophageal wall thickness was measured by endoscopic ultrasonography (EUS).


RESULTS
Patients were seven males and three females with a mean age of 48 years. Symptoms included dysphagia, heartburn, food impaction, and chest pain. Nine patients had a history of allergic diseases. Increased peripheral eosinophil count was observed in one patient whereas increased immunoglobulin E level was observed in eight patients. Endoscopic findings included longitudinal furrows in all patients, mucosal edema in nine patients, loss of vascular pattern in nine patients, white exudates in six patients, cobblestone-like appearance in five patients, and concentric rings in three patients. EUS revealed thickening of the esophageal wall in one patient. Histopathological examination revealed eosinophilic infiltration (≥15 eosinophils/high-powered field) in the esophageal epithelium of all patients. Treatment was required in six patients. Proton pump inhibitor (PPI) therapy was given as the first-line treatment but was ineffective in four patients and effective in two patients. Steroid therapy was given to three patients unresponsive to PPI therapy and was effective.


CONCLUSIONS
EE was common among relatively young men and was associated with allergic diseases. Longitudinal furrows were observed as the most characteristic endoscopic finding. Esophageal wall thickening was not commonly observed by EUS.
Department of Internal Medicine, Banbuntane Hotokukai Hospital, Fujita Health University, School of Medicine, Nagoya, Japan. tomomaty55@yahoo.co.jp
Yuichiro
Y
Tomomatsu
Junji
J
Yoshino
Kazuo
K
Inui
Takao
T
Wakabayashi
Takashi
T
Kobayashi
Hironao
H
Miyoshi
Toshihito
T
Kosaka
Satoshi
S
Yamamoto
Yoshinori
Y
Torii
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D019160:Endosonography; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
D054328:Proton Pump Inhibitors