Prevalence, clinical manifestations and endoscopic features of eosinophilic esophagitis: A pathological review in China

Shi, Yi; Sun, Shi Jun; Xiong, Liang; Cao, Qin; Chen, Yi; Chen, Min Hu

doi:10.1111/j.1751-2980.2012.00593.x

Cited by 40 publications

(34 citation statements)

References 22 publications

(47 reference statements)

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“…(8,17) To date, only a few studies have reported the prevalence of EoE in Chinese or Asians, most of which were conducted in adult Asian populations. (5,6) The condition affects not only adult populations, but also paediatric populations.…”

Section: Discussionmentioning

confidence: 99%

“…However, while EoE is a well-recognised disease in the West, there is little epidemiological data on EoE from nonWestern countries, such as China, Korea and Saudi Arabia. (5)(6)(7) The diagnosis of EoE is predominantly dependent on the patient's clinical presentation, and the endoscopic and histologic findings of mucosal biopsies taken from the oesophagus. Although eosinophil count is used in EoE diagnosis, it is not considered to be the gold standard for EoE diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Eosinophilic oesophagitis in children: an uncommon occurrence in a predominantly Chinese population in Singapore

Tan

Srivastava

Teh

et al. 2017

smedj

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RESULTSOf the 88 children who had biopsies during OGD, 4 (4.5%) children (three boys, one girl; three Chinese, one Caucasian) were diagnosed with EoE. Their median age was 9.5 (range 4.0-12.0) years. The main clinical presentations were abdominal pain (in the three older children) and vomiting (in the youngest child). Three children had a history of atopy. Three children were diagnosed with EoE in the original histology reports, while one was diagnosed after the second review following histology demonstrating > 15 eosinophil granulocytes per high power field and microabscess formation. Endoscopy findings revealed oesophagitis in two children, one of whom was already on acid suppression therapy. Although three children were started on acid suppression therapy, they continued to be symptomatic. One child was also treated with swallowed fluticasone and two with food allergen avoidance, resulting in symptom improvement.CONCLUSION Although EoE is uncommon in Singapore, greater awareness is needed among family physicians and general paediatricians. Paediatric gastroenterologists should alert pathologists when sending biopsy specimens that are suspicious for EoE.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Eosinophilic oesophagitis in children: an uncommon occurrence in a predominantly Chinese population in Singapore

Tan

Srivastava

Teh

et al. 2017

smedj

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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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“…EoE has become increasingly prevalent over the past decade, especially in Western countries [3,4]. While the epidemiology of EoE has not been fully evaluated, it appears that the incidence and prevalence of EoE and esophageal eosinophilia (EE) are also increasing in Asian countries, including Japan [5,6,7,8]. Pathologically, the hallmark of EoE is EE, commonly defined by more than 15 eosinophils per high power field (HPF) in at least 1 esophageal biopsy specimen.…”

Section: Introductionmentioning

confidence: 99%

Reliability of Symptoms and Endoscopic Findings for Diagnosis of Esophageal Eosinophilia in a Japanese Population

Shimura¹,

Ishimura²,

Tanimura

et al. 2014

Digestion

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Background/Aims: The clinical characteristics of esophageal eosinophilia (EE), which is essential for diagnosis of eosinophilic esophagitis (EoE), have not been fully clarified in a Japanese population. The aim of this study was to analyze the reliability of symptoms and endoscopic findings for diagnosing EE in Japanese individuals. Methods: We prospectively enrolled subjects who complained of esophageal symptoms suggesting EoE and/or those with endoscopic findings of suspected EoE at the outpatient clinics of 12 hospitals. Diagnostic utility was compared between the EE and non-EE groups using logistic regression analysis. Results: A total of 349 patients, including 319 with symptoms and 30 with no symptoms but endoscopic findings suggesting EoE were enrolled. Of those with symptoms, 8 (2.5%) had EE, and 3 were finally diagnosed with EoE. Of those without symptoms but endoscopic findings, 4 had EE. Among 8 symptomatic patients, 7 had abnormal endoscopic findings suspicious of EoE. Although dysphagia was a major symptom in EE, none of the presenting symptoms was useful for diagnosis of EE. Among the endoscopic findings, linear furrow was the most reliable (OR = 41.583). Conclusion: EE is uncommon among patients with esophageal symptoms in Japanese individuals. The most useful endoscopic finding for diagnosis of EE was linear furrow, whereas subjective symptoms were not supportive.

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Prevalence, clinical manifestations and endoscopic features of eosinophilic esophagitis: A pathological review in China

Cited by 40 publications

References 22 publications

Eosinophilic oesophagitis in children: an uncommon occurrence in a predominantly Chinese population in Singapore

Eosinophilic oesophagitis in children: an uncommon occurrence in a predominantly Chinese population in Singapore

Esophageal dilations in eosinophilic esophagitis: A single center experience

Reliability of Symptoms and Endoscopic Findings for Diagnosis of Esophageal Eosinophilia in a Japanese Population

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