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Prevalence of Esophageal Eosinophilia and Eosinophilic Esophagitis in Adults: A Population-Based Endoscopic Study in Shanghai, China

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Abstract

Background and Aim

Population-based endoscopic studies of esophageal eosinophilia and eosinophilic esophagitis are limited in the world. This study was aiming to describe features of esophageal eosinophilia and eosinophilic esophagitis in a representative sample of the adult in Shanghai, China.

Methods

As part of a large epidemiological study, 3,600 individuals (aged 18–80 years) were randomly selected in Shanghai, China. They were asked to undergo endoscopy and have at least four esophageal biopsies taken from 0.5 cm above the Z-line and any abnormal areas. Any eosinophil infiltration of the epithelium was defined as esophageal eosinophilia. Eosinophilic esophagitis was defined as ≥15 eosinophils/high-power field in esophageal biopsies.

Results

A total of 1,030 individuals accepted to have endoscopy and 1,021 individuals with biopsy results were suitable for analysis. Esophageal eosinophilia was present in 67 subjects (6.6 %). Eosinophilic esophagitis was present in four cases (0.4 %). No significant association was found between the presence of esophageal eosinophilia and reflux esophagitis, Barrett’s esophagus, symptom-defined gastroesophageal reflux disease or H. pylori infection. Most individuals with esophageal eosinophilia (80.6 %) did not have any of the upper gastrointestinal symptoms.

Conclusions

Esophageal eosinophilia was present in nearly 6.6 % of the general adult population of China; 0.4 % had eosinophilic esophagitis. Most of individuals with esophageal eosinophilia were asymptomatic.

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Acknowledgments

The study, which is part of the SILC study, was funded by AstraZeneca R&D, Mölndal, Sweden, and the program of the Key Discipline Construction of Public Health of Shanghai. We thank the respondents who gave their time and effort to participate in this study.

Conflict of interest

Xiuqiang Ma, Qin Xu, Yanling Zheng, Yanfang Zhao, Jian Lu, Rui Wang, Zhaoshen Li, and Duowu Zou declare that they have no conflict of interest. Jia He has served as the director of the Department of Health Statistics, Second Military Medical University and has received research funding from AstraZeneca.

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    Authors and Affiliations

    1. Department of Health Statistics, Second Military Medical University, Shanghai, 200433, China

      Xiuqiang Ma, Qin Xu, Yanfang Zhao, Jian Lu, Rui Wang & Jia He

    2. Department of Teaching Affairs and Scientific Research, Shandong Medical College, Jinan City, 250002, Shandong Province, China

      Yanling Zheng

    3. Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China

      Zhaoshen Li & Duowu Zou

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    Xiuqiang Ma, Qin Xu, Yanling Zheng and Yanfang Zhao have contributed equally to this work.

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    Ma, X., Xu, Q., Zheng, Y. et al. Prevalence of Esophageal Eosinophilia and Eosinophilic Esophagitis in Adults: A Population-Based Endoscopic Study in Shanghai, China. Dig Dis Sci 60, 1716–1723 (2015). https://doi.org/10.1007/s10620-014-3512-9

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