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

Jiao, Dijin; Ishimura, Norihisa; Maruyama, Riruke; Ishikawa, Noriyoshi; Nagase, Mamiko; Oshima, Naoki; Aimi, Masahito; Okimoto, Eiko; Mikami, Haruo; Izumi, Daisuke; Okada, Minoru; Ishihara, Shunji; Kinoshita, Yoshikazu

doi:10.1007/s00535-016-1213-1

Cited by 38 publications

(32 citation statements)

References 45 publications

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“…We retrospectively enrolled patients with EE, including EoE ( n = 17) and PPI‐REE ( n = 33), as EoE was still rare in Asian populations. Consistent with studies conducted in Western countries, we have recently reported that the clinical characteristics including endoscopic findings did not differ between EoE and PPI‐REE . In this study, the specific endoscopic findings were mainly assessed by viewing endoscopic still photographs, with some cases confirmed by video.…”

Section: Discussionsupporting

confidence: 69%

Specific locations of linear furrows in patients with esophageal eosinophilia

Okimoto

Ishimura

Okada

et al. 2016

Digestive Endoscopy

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Section: Discussionsupporting

confidence: 69%

Specific locations of linear furrows in patients with esophageal eosinophilia

Okimoto

Ishimura

Okada

et al. 2016

Digestive Endoscopy

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“…Subepithelial inflammation may also trigger the destruction of the basal cell layer and lead to upward papillae elongation, but not a downward papillae elongation. Heterogeneity in endoscopic and histological findings has previously been reported in cases of EoE[31]. In fact, cases with “non-EoE-like endoscopic and histological findings” are more likely to represent sEoE than EoE.…”

Section: Discussionmentioning

confidence: 94%

Proposed criteria to differentiate heterogeneous eosinophilic gastrointestinal disorders of the esophagus, including eosinophilic esophageal myositis

Sato

Nakajima

Takahashi

et al. 2017

WJG

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AIMTo define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus.METHODSOur criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis (EoE), subepithelial eosinophilic esophagitis (sEoE) and eosinophilic esophageal myositis (EoEM), identified by endoscopy, manometry and serum immunoglobulin E levels (s-IgE), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples.RESULTSIn five patients with EoE, endoscopy revealed longitudinal furrows and white plaques in all, and fixed rings in two. In one patient with sEoE and four with EoEM, endoscopy showed luminal compression only. Using manometry, failed peristalsis was observed in patients with EoE and sEoE with some variation, while EoEM was associated with hypercontractile or hypertensive peristalsis, with elevated s-IgE. Histology revealed the following eosinophils per high-power field values. EoE = 41.4 ± 7.9 in the epithelium and 2.3 ± 1.5 in the subepithelium; sEoE = 3 in the epithelium and 35 in the subepithelium (conventional biopsy); EoEM = none in the epithelium, 10.7 ± 11.7 in the subepithelium (conventional biopsy or endoscopic mucosal resection) and 46.8 ± 16.5 in the muscularis propria (peroral esophageal muscle biopsy). Presence of dilated epithelial intercellular space and downward papillae elongation were specific to EoE. Eotaxin-3, IL-5 and IL-13 were overexpressed in EoE.CONCLUSIONBased on clinical and histological data, we identified criteria, which differentiated between EoE, sEoE and EoEM, and reflected a different pathogenesis between these esophageal EoGDs.

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“…No significant difference has been shown regarding the treatment efficacy between children and adults, between the dose and number of PPI administered, or between the absence and the presence of GERD [122]. Although evidence of the pathogenesis of PPI-REE and EoE is accumulating, the two entities cannot be clearly differentiated solely based on patient characteristics, symptoms, endoscopic findings, histological findings with immunostaining, or molecular findings [116,123,124]. Thus, some experts have proposed that the responsiveness to PPI should not be included in the diagnostic criteria for EoE, and that use of the term PPI-REE should be avoided [116].…”

Section: Drug: Ppi Therapymentioning

confidence: 99%