Specific locations of linear furrows in patients with esophageal eosinophilia

Okimoto, Eiko; Ishimura, Norihisa; Okada, Minoru; Izumi, Daisuke; Mikami, Haruo; Aimi, Masahito; Tanimura, Takashi; Mishiro, Tsuyoshi; Oshima, Naoki; Ishikawa, Noriyoshi; Ishihara, Shunji; Adachi, Kyoichi; Maruyama, Riruke; Kinoshita, Yoshikazu

doi:10.1111/den.12706

Cited by 18 publications

(20 citation statements)

References 42 publications

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“…For the diagnosis and monitoring of the activities of EoE and EGE, an endoscopic investigation and histological assessment of biopsy specimens are considered to be required ( 1 , 10 , 11 ). However, endoscopic abnormalities are often non-specific and difficult to identify ( 12 - 14 ). Furthermore, histological findings for grading eosinophil infiltration are not always accurate because of the uneven patchy distribution of eosinophils in the esophago-gastro-intestinal mucosa ( 1 , 10 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, endoscopic abnormalities are often non-specific and difficult to identify ( 12 - 14 ). Furthermore, histological findings for grading eosinophil infiltration are not always accurate because of the uneven patchy distribution of eosinophils in the esophago-gastro-intestinal mucosa ( 1 , 10 , 14 ). In addition, an endoscopic examination is invasive, and repeated examinations for activity evaluations are difficult to perform.…”

Section: Introductionmentioning

confidence: 99%

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Serum Biomarkers for the Diagnosis of Eosinophilic Esophagitis and Eosinophilic Gastroenteritis

et al. 2017

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Objective Clinically useful serum biomarkers for the diagnosis and monitoring of eosinophilic gastrointestinal diseases are not available. This study was conducted to examine the possible value of eosinophil-related proteins as serum biomarkers. Methods The serum concentrations of 49 cytokines, chemokines, and other proteins were measured in 29 patients with eosinophilic gastrointestinal diseases and 80 controls. Results The levels of interleukin (IL)-5, IL-33, eotaxin-3, and thymic stromal lymphopoietin (TSLP), previously reported as possible biomarkers of eosinophilic esophagitis, were not significantly elevated in the serum. In contrast, the B cell-attracting chemokine (BCA)-1/chemokine (C-X-C motif) ligand (CXCL) 13 and hemofiltrate C-C chemokine (HCC)-1/CC chemokine ligand (CCL) 14α levels were significantly elevated, while the granulocyte chemotactic protein (GCP)-2/CXCL6 levels were suppressed in patients with eosinophilic esophagitis as well as in those with eosinophilic gastroenteritis. The cutaneus T cell-attracting chemokine (CTACK)/CCL27, stromal cell-derived factor (SDF)-1/CXCL12, macrophage inflammatory protein (MIP)-3β/CCL19, and squamous cell carcinoma antigen (SCCA) 2 levels were elevated only in patients with eosinophilic esophagitis. However, there were large overlaps of data obtained from the patient and control groups, indicating that these serum biomarkers are not adequately sensitive for clinical use with presently available assay systems. Conclusion Of the 49 investigated serum proteins, none were shown to be adequately sensitive for use as biomarkers for the diagnosis or monitoring of eosinophilic gastrointestinal diseases.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum Biomarkers for the Diagnosis of Eosinophilic Esophagitis and Eosinophilic Gastroenteritis

et al. 2017

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“…The position of ABS in relation to esophageal longitudinal folds was also assessed. We recently reported that linear furrows were found to be located in mucosal fold valleys in all affected patients 18 . Interestingly, in all of the present patients with ABS, that was found in esophageal longitudinal mucosal fold ridges, where it did not appear in the valleys.…”

Section: Resultsmentioning

confidence: 91%

Ankylosaurus back sign: novel endoscopic finding in esophageal eosinophilia patients indicating proton pump inhibitor response

et al. 2018

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Background and study aims Characteristic endoscopic findings, such as linear furrows, rings, and whitish exudates, indicate the presence of esophageal eosinophilia (EE), though no specific findings are known to distinguish eosinophilic esophagitis (EoE) from proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE). Here, we present a novel endoscopic finding in some EE patients possessing a linear longitudinal arrangement of whitish nodules with the appearance of the back of an Ankylosaurus dinosaur, termed Ankylosaurus back sign (ABS), and evaluations of its significance in affected patients. Patients and methods Fifty-five patients diagnosed with EE (≥ 15 eosinophils/high power field) who were treated at our hospital and shown to evaluate a PPI response were enrolled. Endoscopic findings at baseline and clinical parameters were retrospectively reviewed. Furthermore, the clinicopathological features of patients with ABS, as well as the relationship between its presence and PPI response were evaluated. Results Fifty-five patients (47 males, 8 females) with EE (17 with EoE, 38 with PPI-REE) were evaluated, of whom 50 (90.9 %) had linear furrows, the most frequently found feature, while ABS was found in 9 (16.4 %). Inter-observer agreement was substantial for ABS (κ 0.77). Interestingly, all patients with ABS had PPI-REE. Our findings revealed that the presence of ABS was closely associated with reflux esophagitis (RE) in patients with PPI-REE. Conclusions Although ABS was less frequent than typical endoscopic findings such as linear furrows in EE, this novel finding was closely associated with PPI-REE accompanied with RE. The clinical implications of ABS in patients with EE should be investigated further.

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“…As mentioned above, the importance of random biopsies has been highlighted, irrespective of endoscopic findings since some EoE patients present with apparently normal mucosa via endoscopy [80]. However, the degree of EE is more intense in the areas containing white exudates [34,105], in linear furrows [32,106], or in the lower esophagus compared with the proximal region [34,104], suggesting that the histological detection of EE may also be influenced by the site of the biopsies in addition to the number of biopsy samples obtained. When the peak of infiltrating eosinophils is \14 eosinophils/HPF in patients suspected of EoE, re-biopsies can aid in the definitive diagnosis of EoE [107].…”

Section: Histological Findingsmentioning

confidence: 99%

Diagnosis and treatment of eosinophilic esophagitis in clinical practice

Abe

Sasaki

Yagi

et al. 2017

Clin J Gastroenterol

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Specific locations of linear furrows in patients with esophageal eosinophilia

Abstract: Investigation of these endoscopic characteristics, especially by focusing on linear furrows in esophageal mucosal fold valleys, may provide important clues for more accurate diagnosis of EoE.

Cited by 18 publications

References 42 publications

Serum Biomarkers for the Diagnosis of Eosinophilic Esophagitis and Eosinophilic Gastroenteritis

Serum Biomarkers for the Diagnosis of Eosinophilic Esophagitis and Eosinophilic Gastroenteritis

Ankylosaurus back sign: novel endoscopic finding in esophageal eosinophilia patients indicating proton pump inhibitor response

Diagnosis and treatment of eosinophilic esophagitis in clinical practice

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