Clinical and endoscopic features of eosinophilic esophagitis in adults
Clinical and endoscopic features of eosinophilic esophagitis in adults
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DOI：
10.1067/s0016-5107(03)01870-4
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发表时间：
2003-10-01
影响因子：
7.7
通讯作者：
Walker, NI
中科院分区：
文献类型：
--
作者：
Croese, J;Fairley, SK;Walker, NI
背景嗜酸性食管炎在成人中被认为是不常见的，大多数被诊断为年轻男性表现为吞咽困难。粘膜沟是内镜下的一个特征。本研究调查了1981年至2002年成人嗜酸性食管炎的人口统计学和临床特征。方法：所有患者来自澳大利亚的一个省级城市（人群198，000）鳞状上皮的其他原因不明的嗜酸性炎症（大于或等于30个嗜酸性粒细胞/高倍视野）纳入回顾性分析。31例患者诊断为嗜酸性食管炎（24例男性，7例女性;平均年龄34岁，范围14-77岁）。31例患者中有19例（61%）是在最近2年内确诊的（1981 - 1994年无，1995-2000年12例，2000 - 2001年19例）。30例（97%）患者出现食管粘膜沟，这一发现在2001年之前很少被发现。26例（89%）记录了吞咽困难。诊断前症状已存在很长时间（平均54个月，范围0-180个月），诊断延迟7（平均81个月，范围20-144个月），因为前哨特征被忽略在内镜检查。17例（57%）出现扩张时粘膜剪切导致的扩张。食管扩张进行17（平均3.4扩张每例患者，范围1-13）一贯缓解症状，眼泪记录在13（87%），但没有严重的并发症resulted.Conclusions：嗜酸性粒细胞性食管炎在所有年龄段的成年人是更常见的比公认的。粘膜沟在内窥镜检查时很容易被忽视，尽管这是诊断的重要线索。扩张是一种常见的后果，可以安全地进行管理。
Background. Eosinophilic esophagitis in adults is regarded as unusual, being diagnosed mostly in young men presenting with dysphagia. Mucosal furrows are a sentinel endoscopic feature. This study examined the demographic and clinical profile of adults with eosinophilic esophagitis seen from 1981 to 2002.Methods: All patients from an Australian provincial city (population 198,000) with otherwise unexplained eosinophilic inflammation of the squamous epithelium (greater than or equal to30 eosinophils per high-power field) were included in a retrospective review.Results: A diagnosis of eosinophilic esophagitis was made in 31 patients (24 men, 7 women; mean age 34 years, range 14-77 years). The diagnosis was made in 19 (61%) of the 31 patients during the most recent 2 years (none between 1981 and 1994 vs. 12 between 1995-2000 vs. 19 between 20002001). Esophageal mucosal furrows were present in 30 (97%), a finding infrequently recognized before 2001. Dysphagia was documented in 26 (89%). Symptoms had been present for long periods before diagnosis (mean 54 months; range 0-180 months), and diagnosis was delayed in 7 (mean 81 months, range 20-144 months) because sentinel features were overlooked at endoscopy. Strictures, often evident only as a result of mucosal shearing during dilation, were present in 17 (57%). Esophageal dilation preformed in 17 (mean 3.4 dilations per patient, range 1-13) consistently relieved symptoms; tears were recorded in 13 (87%), but no serious complication resulted.Conclusions: Eosinophilic esophagitis in adults of all ages is more common than recognized. Mucosal furrows are easily overlooked at endoscopy although this finding is an important clue to diagnosis. Strictures, a frequent consequence, can be safely managed by dilation.