title: Esophagitis with eosinophil infiltration associated with congenital esophageal atresia and stenosis.
abstract: BACKGROUND
  The esophagus is physiologically devoid of eosinophils, so their presence would suggest some underlying pathology. The prevalence of eosinophilic esophagitis (EoE) has steadily increased in Western countries. Previous studies have described EoE in association with congenital esophageal atresia (CEA), which is the most common congenital anomaly of the esophagus. However, the association remains unclear.
  
  
  METHODS
  We performed a retrospective histological analysis examining for eosinophil infiltration in the esophagus of patients with CEA following surgical repair or congenital esophageal stenosis (CES) who underwent esophageal biopsy or surgical resection in our hospital between 2005 and 2012.
  
  
  RESULTS
  There were 6 patients with CEA following surgical repair or CES who had eosinophil-dominant infiltration in the esophagus. All had associated allergic disorders, including food allergies in 4. Moreover, all except for one fulfilled the histological criteria of EoE. Impairment of eosinophil infiltration and symptomatic improvement were observed in those treated with a proton pump inhibitor (PPI), either alone or in combination with steroids after esophageal dilatation.
  
  
  CONCLUSIONS
  These findings suggest that CEA repair or CES in conjunction with allergic conditions and coexisting gastroesophageal reflux disease (GERD) may induce greater esophageal eosinophilic inflammation. In addition, esophageal dilatation followed by PPI treatment, alone or with steroids, may be a therapeutic strategy that can provide symptomatic relief by reducing eosinophilic inflammation in esophageal strictures or GERD associated with CEA or CES.
authors.affiliation: Division of Allergy and Immunology, Gunma Children's Medical Center, Shibukawa, Japan. yamaday@gcmc.pref.gunma.jp
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamada
authors.forename: Akira
authors.initials: A
authors.lastname: Nishi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kato
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Toki
authors.forename: Hideki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Norio
authors.initials: N
authors.lastname: Suzuki
authors.forename: Junko
authors.initials: J
authors.lastname: Hirato
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D057765:Eosinophilic Esophagitis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D004933:Esophageal Atresia / Q000150:complications* / Q000473:pathology / Q000628:therapy; D004940:Esophageal Stenosis / Q000150:complications* / Q000151:congenital / Q000473:pathology / Q000628:therapy; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies