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Similarities and differences among eosinophilic esophagitis, proton-pump inhibitor-responsive esophageal eosinophilia, and reflux esophagitis: comparisons of clinical, endoscopic, and histopathological findings in Japanese patients

  • Original Article—Alimentary Tract
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Abstract

Background

Esophageal eosinophilia is classified as either eosinophilic esophagitis (EoE) or proton-pump inhibitor-responsive esophageal eosinophilia (PPI-REE), depending on the response to PPI treatment. The aim of this study was to compare the clinical, endoscopic, and histopathological findings of EoE and PPI-REE in Japanese patients. In addition, the characteristics of these cases were compared with those of reflux esophagitis (RE) cases.

Methods

Eleven patients diagnosed with EoE, 16 with PPI-REE, and 39 with RE, who were all consecutively examined from 2005 to 2015 at Shimane University Hospital, were enrolled. Clinical, endoscopic, and histopathological esophageal findings in these groups were retrospectively examined and compared.

Results

The differences in the clinical characteristics of EoE and PPI-REE were not remarkable, though patients with EoE and PPI-REE were younger, presented a higher prevalence of allergic comorbidities, and complained of symptoms of dysphagia more frequently than those with RE. The only noteworthy differences between EoE and PPI-REE were more frequent reports of asthma (36.4 vs. 2.6 %) and food allergy (27.3 vs. 0 %) by patients with EoE (P < 0.05, P < 0.05, respectively). Endoscopic findings in patients with EoE and PPI-REE were similar, with the presence of esophageal erosions in a small percentage of PPI-REE cases being the only difference. There were no histopathological differences between EoE and PPI-REE.

Conclusions

Comparisons of clinical, endoscopic, and histopathological findings between EoE and PPI-REE showed that these two types have similar characteristics, though EoE patients showed a higher atopic background. Predicting PPI responsiveness in cases with esophageal eosinophilia is difficult and requires further investigation.

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Acknowledgments

This study was supported by Health and Labour Sciences research grants for research on intractable diseases from the Ministry of Health, Labour and Welfare of Japan.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan

    Dijin Jiao, Norihisa Ishimura, Naoki Oshima, Masahito Aimi, Eiko Okimoto, Hironobu Mikami, Daisuke Izumi, Mayumi Okada, Shunji Ishihara & Yoshikazu Kinoshita

  2. Department of Clinical Pathology, Shimane University School of Medicine, Izumo, Japan

    Riruke Maruyama, Noriyoshi Ishikawa & Mamiko Nagase

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  1. Dijin Jiao
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Correspondence to Norihisa Ishimura.

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Conflict of interest

Yoshikazu Kinoshita has received research grants from AstraZeneca K.K., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., and Takeda Pharmaceutical Co., Ltd. and has performed speaking and teaching commitments for AstraZeneca K.K., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., and Takeda Pharmaceutical Co., Ltd. The following authors have nothing to declare: Dijin Jiao, Norihisa Ishimura, Riruke Maruyama, Noriyoshi Ishikawa, Mamiko Nagase, Naoki Oshima, Masahito Aimi, Eiko Okimoto, Hironobu Mikami, Daisuke Izumi, Mayumi Okada, Shunji Ishihara.

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Jiao, D., Ishimura, N., Maruyama, R. et al. Similarities and differences among eosinophilic esophagitis, proton-pump inhibitor-responsive esophageal eosinophilia, and reflux esophagitis: comparisons of clinical, endoscopic, and histopathological findings in Japanese patients. J Gastroenterol 52, 203–210 (2017). https://doi.org/10.1007/s00535-016-1213-1

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  • DOI: https://doi.org/10.1007/s00535-016-1213-1

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