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Abstract
Background/Aims
Eosinophilic esophagitis (EE) is a chronic inflammatory disorder characterized by abnormal dense eosinophilic infiltration of esophageal mucosa and results in dysphasia and food impaction. EE is being increasingly recognized in adults. The prevalence is largely unknown. This study was performed to evaluate the detection rate of EE diagnosed based on pathologic criteria and to define the clinical characteristics of EE in Korea.
Methods
We reviewed biopsy specimen of the 1,609 patients who underwent esophageal biopsy from January 2006 till August 2008. The presence of more than 20 eosinophils per high power field in biopsy specimens was considered cases of EE. Clinical information and endoscopic findings were obtained.
Results
7 (0.4%) patients were diagnosed as EE based on pathologic criteria retrospectively. Clinical symptoms were epigastric pain (43%), regurgitation (29%), dyspepsia (14%), and no symptom (14%). Endoscopic findings were whitish exudates or granules (57%), esophageal polyp (29%), and hyperemic change (14%). Two patients received treatment. One patient with bronchial asthma improved after treatment with inhaled corticosteroid, and one patient improved after 8 week proton pump inhibitor therapy.
Conclusions
Eosinophilic esophagitis was found in 0.4% of the total esophageal biopsied cases. Our results suggest that Korean patients with eosinophilic esophagitis showed symptoms mimicking gastroesophageal reflux disease and atypical endoscopic findings. Therefore, regardless of the gross appearance of the mucosa, meticulous diagnostic approaches are needed for patients with swallowing diffi-culty and lack of response to proton pump inhibitor.
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Fig. 1.
Endoscopic findings. (A) It showed white exudates and granules (arrowhead) at 25 cm from upper incisors (UI), (B) esophageal polyp at 28 cm from UI, and (C) hyperemic mucosa (arrow) at 36 cm from UI.
Fig. 2.
Pathologic findings (H&E stain, ×400). (A) Biopsy of the esophageal mucosa showed massive infiltration of eosinophils. (B) It showed more than 20 eosinophils on high power field examination.
Table 1.
Frequency of Symptoms, Endoscopic Features and Endoscopic Diagnosis with Eosinophilic Esophagitis
Table 2.
Endoscopic Findings and Eosinophil Counts in 7 Cases of Eosionophilic Esophagitis
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