Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances

Abe, Yasuhiko; Sasaki, Yu; Yagi, Makoto; Mizumoto, Naoko; Onozato, Yusuke; Umehara, Matsuki; Ueno, Yoshiyuki

doi:10.3390/diagnostics12123202

Cited by 5 publications

(3 citation statements)

References 115 publications

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“…Adults with EoE experience dysphagia, reflux, chest discomfort, and pericardial pain; esophageal stenosis occurs with a decrease in esophageal lumen diameter due to pathological tissue remodeling [ 3 ]. Endoscopic findings in EoE frequently include white exudates, mucosal edema, linear furrows, esophageal rings, and stricture of esophageal mucosa [ 4 ]. EoE is common in Caucasian males, with worldwide prevalence rates ranging from 0.5 to 1 case per 1000, and annual incidence rates ranging from 5-10 new cases per 100,000 [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Benralizumab treatment in an elderly patient with eosinophilic esophagitis resulted in remission: a case report

Ishii,

Shibata,

Tsunoda

et al. 2024

BMC Geriatr

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Background Interleukin-5 (IL-5) has recently been shown to play a crucial role in eosinophil-mediated diseases, implying that an IL-5 receptor alpha chain (IL-5Rα) antibody (benralizumab) can be effective against eosinophilic esophagitis (EoE). Here, we present a case in which benralizumab significantly improved the symptoms and signs of an elderly Asian woman with EoE who had inadequate response to existing treatments. Case presentation A 73-year-old woman with an 8-year history of bronchial asthma (BA) and a 7-year history of dysphagia presented to our hospital with worsening dysphagia, vomiting, chest pain, and difficulty in eating. Blood biochemical findings revealed an increase in the eosinophil fraction of white blood cells (42.2%), and a conventional chest computed tomography scan revealed esophageal wall thickening. An upper gastrointestinal endoscopy revealed mucosal edema as well as multiple esophageal rings, and esophageal biopsy specimens showed an eosinophilic infiltrate of more than 15 cells/ high power field. Based on these findings, she was diagnosed as EoE complicated by BA. We firstly administrated 20 mg/day of prednisolone, rabeprazole sodium and liquid budesonide oral suspension for 5 months; however, they were ineffective and her dysphagia worsened over time. Then, benralizumab treatment in combination with these drugs was started. Her dysphagia completely disappeared 2 weeks after starting benralizumab, and an upper endoscopy showed that the clinical findings had completely disappeared after another 6 weeks. Benralizumab was then given to her for 41 months, and her symptoms remained in remission. In addition, she had no EoE recurrence for more than 12 months after discontinuing benralizumab. Conclusions Benralizumab in combination with other multiple drugs significantly improved the symptoms and examination findings of an elderly patients with EoE. Furthermore, she experienced no recurrence even after discontinuing benralizumab withdrawal, suggesting that benralizumab could be an appropriate therapeutic option for EoE.

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Section: Introductionmentioning

confidence: 99%

Benralizumab treatment in an elderly patient with eosinophilic esophagitis resulted in remission: a case report

Ishii,

Shibata,

Tsunoda

et al. 2024

BMC Geriatr

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“…White exudates or plaques, concentric rings, linear furrows as well as friability, are all endoscopic findings in EoE. Serious illness is indicated by narrowing of the lumen and strictures (3) .…”

Section: Introductionmentioning

confidence: 99%

Eosinophilic Esophagitis among Patients with Refractory Gastroesophageal Reflux Disease

Rizk,

Mohamed,

K. ElAlfy

et al. 2024

Benha Medical Journal

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Background: Eosinophilic esophagitis (EoE) may be linked to gastroesophageal reflux disease (GERD) in as many as 30% of patients of EoE. The aim is to study the prevalence and clinical presentation of Eosinophilic esophagitis among patients with refractory GERD. Methods: This cross-sectional study was conducted on 181 patients presented with persistent GERD symptoms despite double dose PPI therapy for at least 8 weeks without interruption, who were referred to gastroenterology unit of Internal Medicine Department at Benha University Hospitals. All patients were subjected to proper and detailed history taking and thorough clinical examination, laboratory investigations including complete blood count with differential leucocytic count and upper gastrointestinal endoscopy and biopsy for histopathological examination. Results: The mean age of the patients was 36.7±11.46 years. One hundred and three (56.9%) patients were males and 78 (43.1%) were females. Among the studied cases, 9 (5.0%) cases had EoE and 2 (1.1%) cases had eosinophilic gastroenteritis. Peripheral eosinophilia was found in 6 (66.7%) of EoE cases. EoE cases had statistically significant higher incidence of atopy, dysphagia, food impaction, furrows, white plaques, concentric rings and strictures compared to refractory GERD patients without EoE (P<0.05). Conclusions: Our results showed that 5% of patients with refractory GERD had EoE. EoE cases had significantly higher association with history of atopy. Most patients with EoE presented with dysphagia and food impaction. Endoscopic features of EoE patients included furrows, white plaques, strictures and concentric rings. EoE cases have higher incidence of having peripheral eosinophilia at their CBCs.

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“…Adults with EoE experience dysphagia, re ux, chest discomfort, and pericardial pain; esophageal stenosis occurs with a decrease in esophageal lumen diameter due to pathological tissue remodeling [3]. Endoscopic ndings in EoE frequently include white specks, mucosal edema, linear grooves, esophageal rings, and stricture of esophageal mucosa [4]. EoE is common in Caucasian males, with worldwide prevalence rates ranging from 0.5 to 1 case per 1000, and annual incidence rates ranging from 5-10 new cases per 100,000 [5].…”

Section: Introductionmentioning

confidence: 99%

Benralizumab treatment resulted in remission of conventional therapy-resistant eosinophilic esophagitis: a case report

Ishii

Shibata

Tsunoda

et al. 2023

Preprint

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Background Interleukin-5 (IL-5) has recently been shown to play a crucial role in eosinophil-mediated diseases, implying that an IL-5 receptor alpha chain (IL-5Rα) antibody (benralizumab) can be effective against eosinophilic esophagitis (EoE). Here, we present a case in which benralizumab significantly improved the symptoms and signs of an elderly Asian woman with EoE who had become resistant to existing treatments. Case presentation: A 73-year-old woman with an 8-year history of asthma and a 7-year history of dysphagia presented to our hospital with worsening dysphagia and other digestive symptoms. Blood biochemical findings revealed an increase in the eosinophil fraction of white blood cells (42.2%), and a conventional chest computed tomography scan revealed esophageal wall thickening. An upper gastrointestinal endoscopy revealed mucosal edema as well as multiple esophageal rings, and esophageal biopsy specimens showed an eosinophilic infiltrate of more than 15 cells/ high power field (HPF). Based on these findings, she was diagnosed as EoE complicated by severe asthma. We firstly administrated 20 mg/day of prednisolone, rabeprazole sodium and budesonide oral therapy; however, they were ineffective and her dysphagia worsened over time. Then, benralizumab treatment in combination with these drugs was started. Her dysphagia completely disappeared 2 weeks after starting benralizumab, and an upper endoscopy showed that the clinical findings had completely disappeared. Benralizumab was then given to her for 41 months, and her symptoms remained in remission. In addition, she had no EoE recurrence for more than 6 months after discontinuing benralizumab. Conclusions Benralizumab in combination with other multiple drugs significantly improved the symptoms and examination findings of an elderly patients with EoE. Furthermore, she experienced no recurrence even after discontinuing benralizumab withdrawal, suggesting that benralizumab is an appropriate therapeutic option for EoE.

show abstract

Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances

Cited by 5 publications

References 115 publications

Benralizumab treatment in an elderly patient with eosinophilic esophagitis resulted in remission: a case report

Benralizumab treatment in an elderly patient with eosinophilic esophagitis resulted in remission: a case report

Eosinophilic Esophagitis among Patients with Refractory Gastroesophageal Reflux Disease

Benralizumab treatment resulted in remission of conventional therapy-resistant eosinophilic esophagitis: a case report

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