title: Reliability of symptoms and endoscopic findings for diagnosis of esophageal eosinophilia in a Japanese population.
abstract: OBJECTIVE
  The clinical characteristics of esophageal eosinophilia (EE), which is essential for diagnosis of eosinophilic esophagitis (EoE), have not been fully clarified in a Japanese population. The aim of this study was to analyze the reliability of symptoms and endoscopic findings for diagnosing EE in Japanese individuals.
  
  
  METHODS
  We prospectively enrolled subjects who complained of esophageal symptoms suggesting EoE and/or those with endoscopic findings of suspected EoE at the outpatient clinics of 12 hospitals. Diagnostic utility was compared between the EE and non-EE groups using logistic regression analysis.
  
  
  RESULTS
  A total of 349 patients, including 319 with symptoms and 30 with no symptoms but endoscopic findings suggesting EoE were enrolled. Of those with symptoms, 8 (2.5%) had EE, and 3 were finally diagnosed with EoE. Of those without symptoms but endoscopic findings, 4 had EE. Among 8 symptomatic patients, 7 had abnormal endoscopic findings suspicious of EoE. Although dysphagia was a major symptom in EE, none of the presenting symptoms was useful for diagnosis of EE. Among the endoscopic findings, linear furrow was the most reliable (OR = 41.583).
  
  
  CONCLUSIONS
  EE is uncommon among patients with esophageal symptoms in Japanese individuals. The most useful endoscopic finding for diagnosis of EE was linear furrow, whereas subjective symptoms were not supportive.
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: Shino
authors.initials: S
authors.lastname: Shimura
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimura
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yuki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyake
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kushiyama
authors.forename: Shuichi
authors.initials: S
authors.lastname: Sato
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Fujishiro
authors.forename: Shunji
authors.initials: S
authors.lastname: Ishihara
authors.forename: Taisuke
authors.initials: T
authors.lastname: Komatsu
authors.forename: Eiji
authors.initials: E
authors.lastname: Kaneto
authors.forename: Akio
authors.initials: A
authors.lastname: Izumi
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Riruke
authors.initials: R
authors.lastname: Maruyama
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001706:Biopsy; D003937:Diagnosis, Differential; D004724:Endoscopy; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results