Korean J Gastroenterol.  2018 Jul;72(1):10-14. 10.4166/kjg.2018.72.1.10.

A Single-center Experience of Esophageal Eosinophilia

Affiliations
  • 1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. hjpark21@yuhs.ac

Abstract

BACKGROUND/AIMS
Esophageal eosinophilia occurs in many conditions, including eosinophilic esophagitis (EoE) and proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE), which have been increasingly recognized in Western countries. There have been only a few reports in Korea. Here, we evaluated the clinical and endoscopic characteristics of patients with esophageal eosinophilia from our experience.
METHODS
Nineteen patients were diagnosed with esophageal eosinophilia based on typical symptoms, endoscopic features, esophageal eosinophilia with ≥15 eosinophils/high power field, and response to medication by PPI. Symptoms, endoscopic and pathological findings were evaluated.
RESULTS
Of the 19 patients, 2 patients were diagnosed with EoE, 7 patients were diagnosed with PPI-REE, and 10 patients were undetermined due to loss to follow-up. Among these 19 patients, dysphagia was present in 11, and heartburn, dyspepsia and reflux in 8. Sixteen patients had common endoscopic features, such as longitudinal furrows, concentric rings, strictures, and white plaques; however, 3 patients had normal findings. Nine patients underwent endoscopy at the time of follow-up. Two patients had complete resolution, and 3 had partial resolution. However, 4 patients showed no endoscopic changes. All patients showed symptom improvements.
CONCLUSIONS
The clinical and endoscopic characteristics of both groups in Korea were undistinguishable. However, after treatment, endoscopic findings were different between the two groups. Large-scale studies are warranted to confirm our findings.

Keyword

Esophagus; Eosinophilia; Proton pump inhibitors

MeSH Terms

Constriction, Pathologic
Deglutition Disorders
Dyspepsia
Endoscopy
Eosinophilia*
Eosinophilic Esophagitis
Esophagus
Follow-Up Studies
Heartburn
Humans
Korea
Proton Pump Inhibitors
Proton Pumps
Proton Pump Inhibitors
Proton Pumps

Figure

  • Fig. 1. Treatment outcomes. (A) Initial endoscopic finding was linear furrow, which disappeared at the follow-up endoscopy (B) with improvement of eosinophilia. (C) Initial endoscopic finding was geographic shape furrow, which was maintained or aggravated at follow-up endoscopy (D) even if, eosinophilia disappeared. (E) Initial endoscopic finding was multiple white plaques with minimal concentric rings. (F) White plaques almost disappeared, but concentric rings remained. Eosinophilia disappeared.


Reference

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