title: Eosinophilic esophagitis: a case report with a review of the literature.
abstract: Eosinophilic esophagitis (EE) is an allergic inflammatory condition of the esophagus and is characterized by dense eosinophilic infiltration of the esophagus. There has been a dramatic increase in the diagnosis of EE in Western countries in recent years; however, in Japan, there are very few reports of EE. We present a rare case of EE in a 70-year-old Japanese woman, who had dysphasia for 2 years, but which worsened over a 6-month period. Laboratory examinations showed peripheral eosinophilia (1279/μl). Significant thickening of the esophageal wall was observed on computed tomography scan and many circular rings appeared when an esophagogastroduodenoscopy was carried out. From these circular rings, EE was suspected and a biopsy was then taken from the esophagus. As the histologic findings from the esophageal biopsy showed that >25 eosinophils existed per high-power field, the patient was diagnosed with EE. Oral corticosteroid (prednisolone 30 mg/day) therapy was administered and after 3 days of treatment her symptoms almost disappeared. EE needs to be considered as a differential diagnosis if patients with non-erosive reflux disease have dysphagia but do not respond to high-dose proton pump inhibitor therapy.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. sph87ke9@way.ocn.ne.jp.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sano
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Iwakiri
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kawami
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Umezawa
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Tadasu
authors.initials: T
authors.lastname: Iizumi
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kotoyori
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.|Clinic of the Ministry of Economy, Trade and Industry, Tokyo, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hoshihara
authors.affiliation: Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Kaiyo
authors.initials: K
authors.lastname: Takubo
authors.affiliation: Division of Gastroenterology, Department of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Choitsu
authors.initials: C
authors.lastname: Sakamoto
keywords: Dysphagia; Eosinophilc esophagitis; Gastroesophageal reflux disease