Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults
Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults
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DOI：
10.4065/78.7.830
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发表时间：
2003-07-01
影响因子：
8.9
通讯作者：
Smyrk, TC
中科院分区：
文献类型：
--
作者：
Arora, AS;Perrault, J;Smyrk, TC
。目的：探讨嗜酸性粒细胞性食管炎患者的临床特点及外用糖皮质激素的治疗方法。患者和方法：我们评估了1999年9月1日至2001年12月31日在明尼苏达州罗切斯特市梅奥诊所诊断为嗜酸性粒细胞性食管炎的1例患者的病历。诊断是基于上内镜检查显示“环状食管”或锥形远端食管，以及食管活检显示致密嗜酸性粒细胞浸润。所有患者均局部用药。皮质类固醇，并通过电话访谈进行随访。结果：17例男性，4例女性，诊断时年龄28 ~ 55岁，平均40岁。所有患者均有至少6年的固体食物吞咽困难，15例患者既往有食物嵌塞。18例患者的食管呈环状或远端呈平滑变细。食道。所有患者食管中远端均有致密的嗜酸性粒细胞浸润（每高倍视场有20个嗜酸性粒细胞）。局部皮质类固醇治疗6周后，所有患者的吞咽困难完全缓解，持续时间至少为4个月。结论：嗜酸性粒细胞性食管炎是一种与食物吞咽困难（主要发生在年轻人）和环状或光滑锥形远端食管相关的实体。我们的研究没有发现与胃食管反流症状相关。局部皮质类固醇治疗有效。
. Objective: To describe the clinical features of patients with eosinophilic esophagitis and the use of topical corticosteroids for treatment.. Patients and Methods: We evaluated the charts of 1 patients with a diagnosis of eosinophilic esophagitis seen at the Mayo Clinic in Rochester, Minn, between September 1, 1999, and December 31, 2001. The diagnosis was based on the presence of a "ringed esophagus" or a tapered distal esophagus on upper endoscopy as well as the presence of a dense eosinophilic infiltrate on esophageal biopsy. All patients were treated with topical. corticosteroids, and follow-up was performed by telephone interviews.. Results: The 17 men and 4 women ranged in age from 28 years to 55 years at diagnosis (mean, 40 years). All had solid-food dysphagia for at least 6 years, and 15 patients had prior food impaction. Eighteen patients had either a ringed-appearing esophagus or smooth tapering in the distal. esophagus. All patients had a dense eosinophilic infiltration (>20 eosinophils per high-power field) in the mid or distal esophagus. Topical corticosteroid therapy for 6 weeks resulted in complete dysphagia relief in all patients and lasted a minimum of 4 months.. Conclusion: Eosinophilic esophagitis is an entity associated with food dysphagia (predominantly in young adults) and a ringed or smooth tapered distal-appearing esophagus. Our study found no association with gastroesophageal reflux symptoms. Topical corticosteroid therapy was effective.