Eosinophil infiltration in the upper gastrointestinal tract of patients with bronchial asthma.
BACKGROUND
Eosinophilic esophagitis (EoE) is related to allergic diseases such as bronchial asthma (BA), atopic dermatitis, and allergic rhinitis. The aim of this study was to examine the eosinophil infiltration in the upper gastrointestinal (GI) tract in patients with BA using esophagogastroduodenoscopy.


METHODS
Patients with BA who had upper GI tract symptoms were enrolled. Patients who received systemically administered steroids were excluded. Eosinophil infiltrations in the esophagus, stomach, and duodenum were examined with regard to the endoscopic findings and pathological findings of biopsy specimens (UMIN000010132).


RESULTS
Ninety patients were enrolled from October in 2012 to September in 2014. Thirty-six were male, 54 were female, and the mean age was 57.5 years. Eighty-one (90%) used inhaled corticosteroids. Fourteen patients (15.6%) had reflux esophagitis, 8 of whom had grade A and 6 had grade B. No patient with EoE was observed. One female patient who had marked eosinophil infiltration in the esophagus, stomach, and duodenum was diagnosed as having eosinophilic gastroenteritis, but endoscopy showed only mucosal edema in the antrum. Another female patient who had marked eosinophil infiltration in the esophagus, stomach, and duodenum was diagnosed as having eosinophilic granulomatosis with polyangiitis, and endoscopy showed erosions in the antrum and the duodenum. Three patients had eosinophil infiltration in the stomach, but none of them had severe symptoms.


CONCLUSIONS
Patients with asthma who had upper gastrointestinal symptoms rarely had eosinophilic gastrointestinal disorders. Biopsy specimens are of high importance in the diagnosis of eosinophilic gastrointestinal disorders even if there is no remarkable endoscopic finding.
Department of General Internal Medicine, Saitama Medical University, Saitama, Japan. Electronic address: imaedahi@yahoo.co.jp.
Hiroyuki
H
Imaeda
Department of General Internal Medicine, Saitama Medical University, Saitama, Japan.
Minoru
M
Yamaoka
Department of General Internal Medicine, Saitama Medical University, Saitama, Japan.
Hideki
H
Ohgo
Department of General Internal Medicine, Saitama Medical University, Saitama, Japan.
Kazuaki
K
Yoneno
Department of General Internal Medicine, Saitama Medical University, Saitama, Japan.
Takehito
T
Kobayashi
Department of General Internal Medicine, Saitama Medical University, Saitama, Japan.
Toru
T
Noguchi
Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan.
Yoshitaka
Y
Uchida
Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan.
Tomoyuki
T
Soma
Department of Pathology, Saitama Medical University, Saitama, Japan.
Hidekazu
H
Kayano
Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan.
Minoru
M
Kanazawa
Department of General Internal Medicine, Saitama Medical University, Saitama, Japan.
Hidetomo
H
Nakamoto
Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan.
Makoto
M
Nagata
D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications / Q000473:pathology*; D004487:Edema / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D004751:Enteritis / Q000150:complications / Q000473:pathology; D004802:Eosinophilia / Q000150:complications / Q000473:pathology; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000473:pathology; D004804:Eosinophils / Q000473:pathology*; D005260:Female; D005756:Gastritis / Q000150:complications / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D041742:Upper Gastrointestinal Tract / Q000473:pathology*; D055815:Young Adult
Asthma; Eosinophil; Eosinophilic esophagitis; Eosinophilic gastroenteritis; Eosinophilic granulomatosis with polyangiitis