| Citation: |
WANG Yanan, ZHAO Xinlu, XU Guifang. A Case Report of Eosinophilic Esophagitis with Dysphagia[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(5): 1152-1156. DOI: 10.12290/xhyxzz.2024-0167
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This paper reports a case of eosinophilic esophagitis who presented with dysphagia. The patient was a 54-year-old woman with diffuse esophageal thickening on ultrasonographic gastroscopy. Pathology demonstrated scattered eosinophilic infiltration within the squamous epithelium of the esophagus, accompanied by eosinophilic microabscess, and the counting density of eosinophilic cells was about 30/HPF, which was consistent with the diagnostic criteria of eosinophilic esophagitis (moderately active). After oral administration of prednisone acetate 30 mg/d and gradual reduction of the dose, the patient's clinical symptoms were significantly eased, and the imaging confirmed the improvement of the lesions. This article summarizes the patient's diagnostic and therapeutic process, and reviews the relevant literature in order to enhance clinicians' understanding of this disease.
| [1] |
Muir A, Falk G W. Eosinophilic esophagitis: a review[J]. JAMA, 2021, 326(13): 1310-1318. DOI: 10.1001/jama.2021.14920
|
| [2] |
Landres R T, Kuster G G, Strum W B. Eosinophilic esophagitis in a patient with vigorous achalasia[J]. Gastroenterology, 1978, 74(6): 1298-1301. DOI: 10.1016/0016-5085(78)90710-2
|
| [3] |
Navarro P, Arias Á, Arias-González L, et al. Systematic review with meta-analysis: the growing incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies[J]. Aliment Pharmacol Ther, 2019, 49(9): 1116-1125. DOI: 10.1111/apt.15231
|
| [4] |
Dellon E S, Hirano I. Epidemiology and natural history of eosinophilic esophagitis[J]. Gastroenterology, 2018, 154(2): 319-332. e3. DOI: 10.1053/j.gastro.2017.06.067
|
| [5] |
Schoepfer A M, Safroneeva E, Bussmann C, et al. Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner[J]. Gastroenterology, 2013, 145(6): 1230-1236. e2. DOI: 10.1053/j.gastro.2013.08.015
|
| [6] |
Warners M J, Oude Nijhuis R A B, De Wijkerslooth L R H, et al. The natural course of eosinophilic esophagitis and long-term consequences of undiagnosed disease in a large cohort[J]. Am J Gastroenterol, 2018, 113(6): 836-844. DOI: 10.1038/s41395-018-0052-5
|
| [7] |
Taft T H, Carlson D A, Simons M, et al. Esophageal hypervigilance and symptom-specific anxiety in patients with eosinophilic esophagitis[J]. Gastroenterology, 2021, 161(4): 1133-1144. DOI: 10.1053/j.gastro.2021.06.023
|
| [8] |
Naik R D, Patel D A. Unlocking the mind might be critical in management of eosinophilic esophagitis: expanding beyond drugs, dilation, and Diet[J]. Gastroenterology, 2021, 161(4): 1099-1101. DOI: 10.1053/j.gastro.2021.07.032
|
| [9] |
Hirano I, Moy N, Heckman M G, et al. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system[J]. Gut, 2013, 62(4): 489-495. DOI: 10.1136/gutjnl-2011-301817
|
| [10] |
Gonsalves N P, Aceves S S. Diagnosis and treatment of eosinophilic esophagitis[J]. J Allergy Clin Immunol, 2020, 145(1): 1-7. DOI: 10.1016/j.jaci.2019.11.011
|
| [11] |
Dellon E S, Khoury P, Muir A B, et al. A clinical severity index for eosinophilic esophagitis: development, consensus, and future directions[J]. Gastroenterology, 2022, 163(1): 59-76. DOI: 10.1053/j.gastro.2022.03.025
|
| [12] |
Dellon E S, Liacouras C A, Molina-Infante J, et al. Updated international consensus diagnostic criteria for eosinophilic esophagitis: proceedings of the AGREE conference[J]. Gastroenterology, 2018, 155(4): 1022-1033. e10. DOI: 10.1053/j.gastro.2018.07.009
|
| [13] |
Steiner S J, Gupta S K, Croffie J M, et al. Correlation between number of eosinophils and reflux index on same day esophageal biopsy and 24 hour esophageal pH monitoring[J]. Am J Gastroenterol, 2004, 99(5): 801-805. DOI: 10.1111/j.1572-0241.2004.04170.x
|
| [14] |
Parfitt J R, Gregor J C, Suskin N G, et al. Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients[J]. Mod Pathol, 2006, 19(1): 90-96. DOI: 10.1038/modpathol.3800498
|
| [15] |
Lee S, De Boer W B, Naran A, et al. More than just counting eosinophils: proximal oesophageal involvement and subepithelial sclerosis are major diagnostic criteria for eosinophilic oesophagitis[J]. J Clin Pathol, 2010, 63(7): 644-647. DOI: 10.1136/jcp.2010.078402
|
| [16] |
Biedermann L, Straumann A. Mechanisms and clinical management of eosinophilic oesophagitis: an overview[J]. Nat Rev Gastroenterol Hepatol, 2023, 20(2): 101-119. DOI: 10.1038/s41575-022-00691-x
|
| [17] |
Schaefer E T, Fitzgerald J F, Molleston J P, et al. Comparison of oral prednisone and topical fluticasone in the treatment of eosinophilic esophagitis: a randomized trial in children[J]. Clin Gastroenterol Hepatol, 2008, 6(2): 165-173. DOI: 10.1016/j.cgh.2007.11.008
|
| [18] |
Tan N D, Xiao Y L, Chen M H. Steroids therapy for eosinophilic esophagitis: systematic review and meta-analysis[J]. J Dig Dis, 2015, 16(8): 431-442. DOI: 10.1111/1751-2980.12265
|
| [19] |
Lucendo A J, Molina-Infante J, Arias Á, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults[J]. United European Gastroenterol J, 2017, 5(3): 335-358. DOI: 10.1177/2050640616689525
|
| [20] |
Dellon E S, Woosley J T, Arrington A, et al. Efficacy of budesonide vs fluticasone for initial treatment of eosinophilic esophagitis in a randomized controlled trial[J]. Gastroenterology, 2019, 157(1): 65-73. e5. DOI: 10.1053/j.gastro.2019.03.014
|
| [21] |
Dellon E S, Rothenberg M E, Collins M H, et al. Dupilumab in adults and adolescents with eosinophilic esophagitis[J]. N Engl J Med, 2022, 387(25): 2317-2330. DOI: 10.1056/NEJMoa2205982
|
| [22] |
Straumann A. Biologics in eosinophilic esophagitis-ready for prime time? [J]. N Engl J Med, 2022, 387(25): 2379-2380. DOI: 10.1056/NEJMe2213030
|
| [23] |
Hirano I, Dellon E S, Hamilton J D, et al. Efficacy of dupilumab in a phase 2 randomized trial of adults with active eosinophilic esophagitis[J]. Gastroenterology, 2020, 158(1): 111-122. e10. DOI: 10.1053/j.gastro.2019.09.042
|
| [24] |
Ridolo E, Barone A, Ottoni M, et al. The new therapeutic frontiers in the treatment of eosinophilic esophagitis: biological drugs[J]. Int J Mol Sci, 2024, 25(3): 1702. DOI: 10.3390/ijms25031702
|
| [25] |
Von Arnim U, Biedermann L, Aceves S S, et al. Monitoring patients with eosinophilic esophagitis in routine clinical practice-international expert recommendations[J]. Clin Gastroenterol Hepatol, 2023, 21(10): 2526-2533. DOI: 10.1016/j.cgh.2022.12.018
|
| [26] |
De Bortoli N, Visaggi P, Penagini R, et al. The 1st EoETALY consensus on the diagnosis and management of eosinophilic esophagitis-definition, clinical presentation and diagnosis[J]. Dig Liver Dis, 2024, 56(6): 951-963. DOI: 10.1016/j.dld.2024.02.005
|
| 1. |
刘敏，杨金苹，赵金颜，乔建红. 老年共病患者自我感知老化、抑郁情绪与生活质量的相关性研究. 心理月刊. 2024(21): 58-60 .
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