Eosinophilic esophagitis-like endoscopic findings in patients with erosive esophagitis

Esophagus ◽  
2013 ◽  
Vol 10 (4) ◽  
pp. 199-204 ◽  
Author(s):  
Yasuhiro Fujiwara ◽  
Tetsuya Tanigawa ◽  
Hirokazu Yamagami ◽  
Kenji Watanabe ◽  
Kazunari Tominaga ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Erosive Esophagitis ◽  
Endoscopic Findings

scholarly journals Eosinophilic Esophagitis in Brazilian Pediatric Patients

2013 ◽  
Vol 7 ◽  
pp. CMPed.S12733 ◽  
Author(s):  
Mayra Isabel Correia Pinheiro ◽  
Luciano Pamplona De Góes Cavalcanti ◽  
Rodrigo Schuler Honório ◽  
Luïs Hélder De Alencar Moreno ◽  
Mayara Carvalho Fortes ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Topical Corticosteroid ◽  
Eosinophilic Esophagitis ◽  
Pediatric Patients ◽  
Erosive Esophagitis ◽  
Normal Mucosa ◽  
Patient Treatment ◽  
Therapeutic Approaches ◽  
Endoscopic Findings ◽  
The Mean

We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils.

224 A RETROSPECTIVE CASE–CONTROL STUDY ASSESSING THE CLINICAL AND ENDOSCOPIC CHARACTERISTICS OF EOSINOPHILIC ESOPHAGITIS IN JAPAN

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Kazumi Imamura ◽  
Ken Haruma ◽  
Hiroshi Matsumoto ◽  
Yasuhiko Maruyama ◽  
Maki Ayaki ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Japanese Population ◽  
Case Control Study ◽  
High Power Field ◽  
Retrospective Case ◽  
Male Predominance ◽  
Endoscopic Findings ◽  
History Of ◽  
Endoscopic Characteristics ◽  
Control Study

Abstract   Eosinophilic esophagitis (EoE) is an allergy-associated clinicopathologic condition gaining an increasing amount of recognition in various areas of the world. While the clinical definition and characteristics may differ depending on country and region, sufficient studies have not yet been performed in Japan. To assess the prevalence of EoE among the Japanese population and the clinical features and the prognosis associated with the disease. Methods Medical data from January 2012 to October 2018 was gathered from nine Japanese clinical institutes. EoE, defined as more than 15 intraepithelial eosinophils per high power field, was determined based on esophageal biopsies. Clinical and endoscopic patterns in the cases with EoE were investigated and compared with 186 age- and sex-matched controls. We also analyzed the treatment and prognosis of an individual patient. Results From 130,013 upper endoscopic examinations, 66 cases of EoE were identified (0.051%; mean age: 45.2 years (range 7-79); 45 males). Patients with EoE had more symptoms (69.7 vs. 10.8%; P < 0.01) such as dysphagia and food impaction, and more allergies (63.6 vs. 23.7%; P < 0.01) compared with the controls. The prevalence of atrophic gastritis was lower in EoE patients than in the controls (20.0% vs. 33.3%). In 55 patients analyzed, 32 patients (78.0%) received proton pump inhibitors with or without swallowed topical corticosteroids. During the follw-up period (mean 23 months), no patient got worse regarding clinical and endoscopic findings. Conclusion The prevalence of EoE in the Japanese population was 0.051% which was comparable with previous reports in Japan. Male predominance, a history of allergies, and the absence of Helicobacter pylori infection might be risk factors for EoE. Our study also indicated that the prognosis of EoE might be relatively good in Japanese populations.

scholarly journals Association between endoscopic findings of eosinophilic esophagitis and responsiveness to proton pump inhibitors

2019 ◽  
Vol 07 (04) ◽  
pp. E433-E439 ◽  
Author(s):  
Akinari Sawada ◽  
Atsushi Hashimoto ◽  
Risa Uemura ◽  
Koji Otani ◽  
Fumio Tanaka ◽  
...  
Keyword(s):  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Acid Reflux ◽  
Diffuse Type ◽  
High Power Field ◽  
Lower Esophagus ◽  
Small Areas ◽  
Endoscopic Findings ◽  
Esophageal Eosinophilia ◽  
Asymptomatic Patients

Abstract Background and study aims Endoscopic findings of esophageal eosinophilia sometimes localize to small areas of the esophagus. A previous study suggested that pathogenesis of localized-type eosinophilic esophagitis (LEoE) was associated with acid reflux. However, LEoE treatment outcomes have not been studied. We aimed to analyze the clinical and histologic significance of LEoE in comparison with diffuse-type eosinophilic esophagitis (DEoE). Patients and methods This study included 106 patients with esophageal eosinophilia. Esophageal eosinophilia was defined as a condition where the maximum number of intraepithelial eosinophils was ≥ 15 per high-power field. LEoE was defined as an endoscopic lesion confined to one-third of the esophagus: upper, middle, or lower. Esophageal eosinophilia encompassing more than two-thirds of the esophagus was defined as DEoE. We retrospectively compared LEoE and DEoE in terms of clinical characteristics, histologic findings, and proportion of proton pump inhibitor (PPI) responders. Results Of 106 patients, 12 were classified as having LEoE and 94 were classified as having DEoE. The proportion of asymptomatic patients was significantly higher in the LEoE group than the DEoE group (42 % vs 7 %, P < 0.01). In the LEoE group, 10 patients (84 %) had endoscopic lesions in the lower esophagus. The maximum number of eosinophils did not differ between the groups (54 [24 – 71] for LEoE, 40 [20 – 75] for DEoE, P = 0.65). The prevalence of PPI responders was significantly higher in the LEoE group than the DEoE group (100 % vs 63 %, P = 0.01). Conclusion LEoE can be a sign of good responsiveness to PPI therapy.

scholarly journals Endoscopic findings of gastric lesions in patients with eosinophilic gastrointestinal disorders

2020 ◽  
Vol 08 (12) ◽  
pp. E1817-E1825
Author(s):  
Yasuhiro Fujiwara ◽  
Kojiro Tanoue ◽  
Akira Higashimori ◽  
Yu Nishida ◽  
Masatsugu Maruyama ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Submucosal Tumor ◽  
Eosinophilic Gastroenteritis ◽  
Gastrointestinal Disorders ◽  
Gastric Lesions ◽  
Pyloric Ring ◽  
Eosinophilic Colitis ◽  
Endoscopic Findings ◽  
Eosinophilic Gastritis ◽  
Eosinophilic Gastrointestinal Disorders

Abstract Background and study aims Eosinophilic gastrointestinal disorders are classified into eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, and eosinophilic colitis according to the site of eosinophilic infiltration. Although well established in eosinophilic esophagitis, endoscopic findings in eosinophilic gastritis and eosinophilic gastroenteritis with regard to gastric lesions have not been clearly described. The aim of this study was to identify endoscopic findings of gastric lesions associated with eosinophilic gastrointestinal disorders. Patients and methods Out of 278 patients with eosinophilic gastrointestinal disorders, 18 had eosinophilic gastritis or eosinophilic gastroenteritis confirmed by biopsy; their endoscopic images were analyzed retrospectively. The association between endoscopic findings and number of eosinophils in the gastric mucosa was investigated. Results Erythema was most frequently observed (72 %), followed by ulcers (39 %), discoloration (33 %), erosions (28 %), nodularity (28 %), and polyps (28 %). There were several unique endoscopic findings such as submucosal tumor-like deep large ulcers in three patients, antral Penthorum-like appearances (small nodules radially lined toward the pyloric ring) in three patients, “muskmelon-like appearances” (discolored mucosa-composed mesh pattern) in three patients, multiple white granular elevations in two patients, cracks (appearance of furrows similar to those in eosinophilic esophagitis) in five patients, and antral rings in one patient. No significant association was observed between endoscopic findings and number of gastric eosinophils. Conclusions Several unique endoscopic findings of gastric lesions were observed in patients with eosinophilic gastritis or eosinophilic gastroenteritis. Submucosal tumor-like ulcers, antral Penthorum-like appearances, muskmelon-like appearances, and cracks might be associated with eosinophilic gastrointestinal disorders.

scholarly journals Eosinophilic Esophagitis in Children in North-Eastern Poland

2020 ◽  
Vol 9 (12) ◽  
pp. 3869 ◽  
Author(s):  
Katarzyna Zdanowicz ◽  
Magdalena Kucharska ◽  
Maria Elzbieta Sobaniec-Lotowska ◽  
Dariusz Marek Lebensztejn ◽  
Urszula Daniluk
Keyword(s):  
Eosinophilic Esophagitis ◽  
Biochemical Markers ◽  
Clinical Manifestations ◽  
Vascular Pattern ◽  
Newly Diagnosed ◽  
Male Predominance ◽  
Endoscopic Findings ◽  
Significant Difference ◽  
North Eastern ◽  
Histopathological Results

Background: An increase in the incidence of eosinophilic esophagitis worldwide is being observed in children. The aim of the study was to analyze the incidence, clinical manifestations, biochemical markers and endoscopic features of children with eosinophilic esophagitis in comparison to patients with non-eosinophilic esophagitis. Methods: This single-center retrospective study included newly diagnosed children with eosinophilic (EoE) and non-eosinophilic (non-EoE) esophagitis based on endoscopic and histopathological results between January 2013 and December 2018. Result: Among 433 of enrolled children with esophagitis, 36 (8.31%) were diagnosed with EoE (median age of 10 years). Male predominance and an increased percentage of allergy cases in the EoE group were noticed. Dysphagia was the only symptom that significantly differentiated both groups (p = 0.006). Endoscopic findings with relevant relationships with EoE included linear fissuring, decreased vascular pattern, trachealization and whitish exudates. No significant difference in the prevalence of other reported diseases between groups was observed. Conclusion: The results of EoE analysis in children from North-Eastern Poland did not differ from reports from other countries. The reported symptoms were not specific for EoE, and only dysphagia and some endoscopic lesions were helpful to differentiate children with EoE from non-EoE.

scholarly journals Treatment with compounded fluticasone suspension improves the clinical, endoscopic, and histologic features of eosinophilic esophagitis

2020 ◽  
Author(s):  
Corey J Ketchem ◽  
Craig C Reed ◽  
Zoe Stefanadis ◽  
Evan S Dellon
Keyword(s):  
Eosinophilic Esophagitis ◽  
Medical Records ◽  
Clinical Care ◽  
The United States ◽  
Food Impaction ◽  
Histologic Response ◽  
Off Label ◽  
Endoscopic Findings ◽  
Loss Of Response ◽  
Routine Clinical Care

Summary No approved medication exists for the treatment of eosinophilic esophagitis (EoE) in the United States, which forces patients to utilize off-label drugs and/or create their own formulations. We assessed the efficacy of a standardized compounded fluticasone suspension. To do this, we performed a retrospective cohort study identifying all EoE patients treated with compounded fluticasone. Compounded fluticasone was prescribed during routine clinical care and dispensed by a specialty compounding pharmacy. Clinical data were extracted from medical records. Outcomes (symptomatic, endoscopic, and histologic) were assessed after the initial and last compounded fluticasone treatment in our system. There were 27 included patients (mean age 34.2; 67% male; 96% white) treated for a mean length of 5.4 ± 4.4 months. The majority (89%) previously utilized dietary elimination or topical corticosteroids, and many (75%) had primary non-response or secondary loss of response to these treatments. After starting compounded fluticasone, symptoms and endoscopic findings improved [dysphagia (89 vs. 56%, P = 0.005), food impaction (59 vs. 4%, P = 0.003), heartburn (26 vs. 4%, P = 0.01), chest pain (26 vs. 8%, P = 0.05), white plaques (63 vs. 32%; P = 0.005), furrows (81 vs. 60%; P = 0.06), and edema (15 vs. 4%; P = 0.16)]. The median of the peak eosinophil counts decreased from 52 to 37 eos/hpf (P = 0.10) and 35% of patients achieved &lt;15 eos/hpf. In conclusion, compounded fluticasone provided a significant improvement in symptoms and endoscopic findings, with more than a third achieving histologic response in a treatment refractory EoE population. Compounded fluticasone should be considered as an EoE management option.

Sign in / Sign up

Export Citation Format

Share Document