3-Yr-Follow-Up of Topical Corticosteroid Treatment for Eosinophilic Esophagitis in Adults
3-Yr-Follow-Up of Topical Corticosteroid Treatment for Eosinophilic Esophagitis in Adults
复制标题
DOI：
10.1111/j.1572-0241.2008.01989.x
复制
发表时间：
2008-09-01
影响因子：
9.8
通讯作者：
Arora, Amindra S.
中科院分区：
文献类型：
--
作者：
Helou, Emelie F.;Simonson, Julie;Arora, Amindra S.
背景：嗜酸性食管炎(EE)是一种临床病理综合征，包括孤立的食管嗜酸性炎症，伴有吞咽困难的症状，可能还有反流。它最初是在儿童中描述的，近年来，成年人的意识有所提高。其病因尚不完全清楚。治疗包括饮食控制、局部皮质类固醇、全身皮质类固醇、孟鲁司特和内窥镜扩张。在成人中，没有随机试验证明任何特定治疗的有效性，也没有前瞻性研究描述治疗后疾病的自然历史。方法：我们对接受吞咽皮质类固醇吸入器治疗的患者进行了间隔随访。我们联系了1999年9月1日至2003年5月31日确诊为EE的51例成人患者，所有患者均接受了氟替卡松220mEq/泡芙6wk的治疗，每天2次吞咽4次，共6wk。结果：32例患者得到回复(63%)，平均随访时间3.3年。91%的患者报告症状复发；平均在治疗完成后8.8个月。69%的患者至少重复使用一次类固醇吸入器治疗。结论：EE似乎是一种慢性缓解性疾病，需要一个以上的局部类固醇治疗疗程。
BACKGROUND: Eosinophilic esophagitis (EE) is a clinicopathologic syndrome comprising isolated eosinophilic inflammation of the esophagus, with symptoms of dysphagia, and possibly, reflux. It was initially described in children, and in recent years, there is a heightened awareness in adults. The etiology is not completely understood. The treatments include dietary manipulation, topical corticosteroids, systemic corticosteroids, Montelukast, and endoscopic dilation. In adults, there are no randomized trials demonstrating the efficacy of any particular treatment, and no prospective studies describing the natural history of the disease following treatment.METHODS: We performed an interval follow-up of patients treated with a swallowed corticosteroid inhaler. We contacted 51 adult patients who were diagnosed with EE and treated with a swallowed corticosteroid inhaler between September 1, 1999, and May 31, 2003, All patients had received 6 wk of treatment with fluticasone 220 mEq/puff, four puffs swallowed twice daily for 6 wk.RESULTS: Thirty-two patients replied (63%) with a mean follow-up duration of 3.3 yr. Ninety-one percent of patients reported recurrent symptoms; a mean of 8.8 months after treatment was completed. Sixty-nine percent of patients repeated treatment with the steroid inhaler at least once.CONCLUSIONS: It appears that EE is a chronic remitting disorder that requires more than one topical steroid treatment course.