Eosinophilic esophagitis investigated by upper gastrointestinal endoscopy in Japanese patients

Fujishiro, Hirofumi; Amano, Yuji; Kushiyama, Yoshinori; Ishihara, Shunji; Kinoshita, Yoshikazu

doi:10.1007/s00535-011-0435-5

Cited by 75 publications

(65 citation statements)

References 19 publications

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“…Although there are many studies of EoE from Western counties (5-10), there are only a few case reports or series of adult EoE in Asia (11)(12)(13)(14)(15). Only 1 case of an asymptomatic Chinese patient with EoE was reported in 2008 (12).…”

Section: Discussionmentioning

confidence: 99%

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A Multicenter Study on the Prevalence of Eosinophilic Esophagitis and PPI-Responsive Esophageal Eosinophilic Infiltration

et al. 2012

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Objective Eosinophilic esophagitis (EoE) is diagnosed by the presence of dysphagia and intraepithelial eosinophilic infiltration of ! 15 per high-power field (HPF). EoE should be distinguished from proton pump inhibitor-responsive esophageal eosinophilic infiltration (PPI-R EEI) in patients that are responsive to PPI treatment. The aim of this study was to determine the prevalence of EoE and PPI-R EEI in Japanese patients in a multicenter study. Methods Ten hospitals participated in this study. Esophageal biopsy was performed when the patients had typical EoE symptoms or when endoscopic findings revealed a typical EoE appearance. EEI was defined as the intraepithelial eosinophilic infiltration of ! 15 per HPF. Patients with EEI received rabeprazole for 8 weeks to distinguish EoE from PPI-R EEI. Results A total of 13,634 subjects that underwent upper gastrointestinal endoscopy because of further examination or as a routine checkup were enrolled. Seventy-one (0.5%) patients suspected with EoE were examined by biopsy. A histological examination of 7 (9.9%) cases revealed EEI. Two of these 7 patients showed no symptoms and the other 5 were treated with PPI. Two (0.01%) patients were diagnosed with EoE and 3 (0.02%) with PPI-R EEI. Conclusion EoE and PPI-R EEI were rare in Japanese patients that underwent upper gastrointestinal endoscopy.

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Section: Discussionmentioning

confidence: 99%

“…Most Western studies show a significant increase in the rate of EoE (7,8). However, there are only a few studies on EoE conducted in Asia, including Japan (11)(12)(13)(14)(15). The purpose of this study was to determine the prevalence of EoE and PPI-R EEI in Japanese adult patients in a multicenter study.…”

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confidence: 99%

A Multicenter Study on the Prevalence of Eosinophilic Esophagitis and PPI-Responsive Esophageal Eosinophilic Infiltration

et al. 2012

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“…Based on recent studies, the prevalence of EoE is lower in Asia with reported rate 0.34% in China [25] and 0.02% of the routine endoscopies in Japan [26] . In adults with EoE, solid food dysphagia is the most common presenting symptom, followed by food impaction.…”

Section: Complications No Complicationsmentioning

confidence: 99%

Esophageal dilations in eosinophilic esophagitis: A single center experience

Ukleja

Shiroky

Agarwal

et al. 2014

WJG

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AIM: To diagnose the clinical and histologic features that may be associated with or predictive of the need for dilation and dilation related complications; examine the safety of dilation in patients with eosinophilic esophagitis (EoE). METHODS:The medical records of all patients diagnosed with EoE between January 2002 and July 2010 were retrospectively reviewed. Esophageal biopsies were reexamined by an experienced pathologist to confirm the diagnosis (≥ 15 eos/hpf per current guidelines). Patients were divided into 2 groups: patients who did not receive dilation therapy and those who did. Demographics, clinical history, the use of pharmacologic therapy, endoscopic and pathology findings, and the number of biopsies and dilations carried out, if any, and their locations were recorded for each patient. The dilation group was further examined based on the interval between diagnosis and dilation, and whether or not a complication occurred. RESULTS:Sixty-one patients were identified with EoE and 22 (36%) of them underwent esophageal dilations for stricture/narrowing. The peak eos/hpf was significantly higher in patients who received a dilation (P = 0.04). Four (18% of pts.) minor complications occurred: deep mucosal tear 1, and small mucosal tears 3. There were no cases of esophageal perforations. Higher peak eos/hpf counts were not associated with increased risk of complications. CONCLUSION:Esophageal dilation appears to be a safe procedure in EoE patients, carrying a low complication rate. No correlation was found between the peak of eosinophil count and complication rate. Complications can occur independently of the histologic features. The long-term outcome of EoE treatment, with or without dilation, needs to be determined. © 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Balloon dilation; Dysphagia; Esophagus disorder; Esophageal stricture; Esosinophilic esophagitis Core tip: The field of gastroenterology does not currently have standardized treatment guidelines for eosinophilic esophagitis. Current data on the safety of dilations in patients with eosinophilic esophagitis (EoE) are conflicting and lack information on factors that influence whether or not a patient will require dilation. This study revealed that higher peak eos/hpf counts appear to influence whether or not an EoE patient will require dilation during the course of their treatment. However, complications appear to occur independently of the histologic features. Esophageal dilation appears to be a safe procedure in EoE patients, carrying a low complication rate.

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“…The prevalence of EE or EoE is estimated to be 0.02-6.6% (Table 1) in the recent studies reported from the east Asia including Japan, in which studied population have undergone an endoscopy for a health check-up or for gastrointestinal symptoms suggestive of EoE [29][30][31][32][33][34][35][36][37]. The number of the patients enrolled in Asian reports is approximately 20 at most, much lower than that in the Western reports.…”

Section: Epidemiologymentioning

confidence: 95%

“…High doses of PPIs (e.g., omeprazole 40 mg twice daily) are initially used in PPI therapy; however, 70-80% of patients may maintain histological remission with lower doses of PPI (e.g., omeprazole 20 mg twice or once daily) [125,126]. In Japan, at least 15-50% of patients achieve clinicopathological remission with the standard PPI dose used for the treatment of GERD (e.g., omeprazole 20 mg once a day, rabeprazole 10 mg once a day) [11,[29][30][31]. In a pediatric case series, it was reported that PPI-REE is a potentially transient phenomenon [127].…”

Section: Drug: Ppi Therapymentioning

confidence: 99%

Diagnosis and treatment of eosinophilic esophagitis in clinical practice

Abe

Sasaki

Yagi

et al. 2017

Clin J Gastroenterol

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Eosinophilic esophagitis investigated by upper gastrointestinal endoscopy in Japanese patients

Abstract: The prevalence of EE in Japanese patients by upper gastrointestinal endoscopy has now been documented.

Cited by 75 publications

References 19 publications

A Multicenter Study on the Prevalence of Eosinophilic Esophagitis and PPI-Responsive Esophageal Eosinophilic Infiltration

A Multicenter Study on the Prevalence of Eosinophilic Esophagitis and PPI-Responsive Esophageal Eosinophilic Infiltration

Esophageal dilations in eosinophilic esophagitis: A single center experience

Diagnosis and treatment of eosinophilic esophagitis in clinical practice

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