J Neurogastroenterol Motil.  2018 Apr;24(2):248-254. 10.5056/jnm17047.

Diagnostic Trends and Clinical Characteristics of Eosinophilic Esophagitis: A Korean, Single-center Database Study

Affiliations
  • 1Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea (Current address). hyjung@amc.seoul.kr
  • 2Department of Health Promotion Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul, Korea.
  • 3Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 4Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract

BACKGROUND/AIMS
The prevalence of eosinophilic esophagitis (EoE) is reportedly increasing in Western countries. However, its prevalence in Korea remains unknown. We investigated the diagnostic trends and clinical characteristics of EoE in Korea.
METHODS
Using an endoscopic database maintained at a tertiary care center, we retrospectively reviewed the biopsy reports regarding 18 399 biopsy specimens collected from all patients who underwent esophagogastroduodenoscopy and esophageal biopsy at this facility between 2006 and 2014. The presence of more than 15 eosinophils per high-power field with symptoms related to esophageal dysfunction was considered to indicate EoE.
RESULTS
A total of 37 patients (male:female ratio, 29:8; mean age, 44.0 ± 13.0 years) were diagnosed with EoE. These patients presented with dysphagia (21.6%), epigastric pain (21.6%), heartburn (24.3%), and other symptoms (32.4%). Typical endoscopic appearance of EoE was noted in 33 cases (89.1%) and included linear furrows in 24 cases (64.8%), ringed esophagus in 10 cases (27.0%), and white exudates in 11 cases (29.7%). The median eosinophilic count was 25 per high-power field (interquartile range, 20–70). Notable histopathological findings included eosinophilic microabscesses in 21 cases (56.7%). The diagnosis rate of EoE was found to have increased from 2006 and to 2014 (P-value < 0.001 by the Cochran-Armitage trend test).
CONCLUSIONS
The number of patients with EoE appears to have increased significantly over the 9-year period investigated, while the number of endoscopic investigations increased only marginally. Greater awareness of EoE and the role of esophageal biopsies should be considered.

Keyword

Dysphagia; Endoscopy; Eosinophilic esophagitis; Esophagus
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