scholarly journals The First Asian Case Report of Eosinophilic Esophagitis in an Asymptomatic Adult: What About a Proton Pump Inhibitor Trial?

2009 ◽  
Vol 72 (3) ◽  
pp. 166-167 ◽  
Author(s):  
Javier Molina-Infante ◽  
Moises Hernandez-Alonso ◽  
Belen Perez-Gallardo ◽  
Elisa Martin-Noguerol
Keyword(s):  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Asymptomatic Adult

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

Empiric proton pump inhibitor therapy after esophageal food impaction may mask eosinophilic esophagitis diagnosis at follow-up

2021 ◽  
Author(s):  
Luke Hillman ◽  
Sarah Donohue ◽  
Aimee Teo Broman ◽  
Patrick Hoversten ◽  
Eric Gaumnitz ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Empiric Therapy ◽  
Proton Pump Inhibitor Therapy ◽  
Significant Heterogeneity ◽  
Food Impaction ◽  
Esophageal Food Impaction ◽  
The Impact

Summary Esophageal food impaction (EFI) is often the first presentation for patients with eosinophilic esophagitis (EoE); however, there is significant heterogeneity in the management of EFI. We aimed to study the impact of EFI management, particularly post-EFI medication prescriptions on EoE diagnosis, follow-up, and recurrence in patients with endoscopic features of EoE. In our retrospective study, adults presenting between 2007 and 2017 with EFI requiring endoscopic dis-impaction with endoscopic features of EoE (furrows, rings, and/or exudates) were included. We examined the impact of demographics and EFI management on EoE diagnosis, follow-up (esophagogastroduodenoscopy [EGD] or clinic visit within 6 months), and recurrence. We identified 164 cases of EFI due to suspected EoE. Biopsy was performed in 68 patients (41.5%), and 144 patients (87.8%) were placed on proton pump inhibitor (PPI) and/or swallow corticosteroids after EFI, including 88.5% of those not biopsied. PPI use at time of biopsy was negatively associated with EoE diagnosis (odds ratio: 0.39, confidence interval: 0.17–0.85). Sixty-one (37.4%) patients were lost to follow-up at 6 months. Recurrent EFI at 1 year occurred in 3.7% of patients. Medications, most commonly PPI, are frequently prescribed after EFI when the endoscopic features of EoE are present, which may mask the diagnosis of EoE on follow-up EGD. We estimated that for every five patients biopsied on PPI, one case of EoE is masked. As recurrent EFI within 1 year is uncommon, empiric therapy should be avoided until diagnostic biopsies are obtained. Further efforts to reduce loss to follow-up after EFI are also needed.

Case report of severe iron deficiency anemia caused by proton pump inhibitor in an elderly patient

2017 ◽  
Vol 17 (4) ◽  
pp. 662-663 ◽  
Author(s):  
Suguru Mabuchi ◽  
Risa Suzuki ◽  
Mari Sasaki ◽  
Marie Nakamura ◽  
Norihiko Izumimoto ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Iron Deficiency ◽  
Proton Pump Inhibitor ◽  
Iron Deficiency Anemia ◽  
Proton Pump ◽  
Deficiency Anemia

scholarly journals Histologic similarities in children with eosinophilic esophagitis and proton pump inhibitor–responsive esophageal eosinophilia

2019 ◽  
Vol 143 (3) ◽  
pp. 1237-1240.e2 ◽  
Author(s):  
Nathalie Nguyen ◽  
Anna Baumgarten ◽  
Benjamin L. Wright ◽  
Kelley E. Capocelli ◽  
Zhaoxing Pan ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Esophageal Eosinophilia

Su1106 Esophageal Basophil Infiltration Is a Novel Marker to Distinguish Eosinophilic Esophagitis From Proton Pump Inhibitor-Responsive Esophageal Eosinophilia

2015 ◽  
Vol 148 (4) ◽  
pp. S-409
Author(s):  
Narika Park ◽  
Yasuhiro Fujiwara ◽  
Hirokazu Yamagami ◽  
Tetsuya Tanigawa ◽  
Masatsugu Shiba ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Esophageal Eosinophilia

Su1845 Eosinophilic Esophagitis and Proton Pump Inhibitor Responsive Esophageal Eosinophilia: Are They One and the Same?

2013 ◽  
Vol 144 (5) ◽  
pp. S-489 ◽  
Author(s):  
Fouad J. Moawad ◽  
Alain Schoepfer ◽  
Mazer R. Ally ◽  
Ekaterina Safroneeva ◽  
Corinne L. Maydonovitch ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Esophageal Eosinophilia

scholarly journals The Predictive Factors of Responsiveness to Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis

2019 ◽  
Vol 1 (1) ◽  
pp. 220-230
Author(s):  
Atsushi Hashimoto ◽  
Takashi Sugawa ◽  
Narika Iwakura ◽  
Risa Uemura ◽  
Akinari Sawada ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Predictive Factors ◽  
Eosinophilic Esophagitis ◽  
Reflux Esophagitis ◽  
Odds Ratio ◽  
Proton Pump Inhibitor Therapy ◽  
High Power Field ◽  
Factors Associated

Approximately half of patients with eosinophilic esophagitis (EoE) respond clinically and histologically to proton pump inhibitor (PPI) therapy. Although recent guidelines suggest that PPI-responders and non-responders were included in EoE, it is important to investigate the predictive factors of PPI- responsiveness. This study aimed to determine the rate of PPI- responders and compare the characteristics of PPI-responders and non-responders. Fifty-nine patients with esophageal eosinophilia received PPI therapy for eight weeks, and its efficacy was assessed. PPI- responsiveness was diagnosed based on the relief in symptoms and reduction of intraepithelial eosinophilic infiltration to <15 per high-power field (hpf) after PPI therapy. Multivariate analysis was performed to identify factors associated with PPI-responders. Of the 59 patients, 41 (69.5%) were diagnosed with PPI-responders. The rate of gastrointestinal (GI) screening in the indications for endoscopy was significantly higher in patients with PPI- responders than in those with non-responders. On multivariate analysis, GI screening and presence of reflux esophagitis was associated with an increased odds ratio (OR) of PPI-responders, but presence of rings with a decreased OR of PPI-responders. Presence of reflux esophagitis and absence of rings on endoscopy especially during GI screening might be significant predictive factors for PPI response in patients with EoE.

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