論文

国際誌
2017年4月7日

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

World journal of gastroenterology
  • Hiroki Sato
  • Nao Nakajima
  • Kazuya Takahashi
  • Go Hasegawa
  • Ken-Ichi Mizuno
  • Satoru Hashimoto
  • Satoshi Ikarashi
  • Kazunao Hayashi
  • Yutaka Honda
  • Junji Yokoyama
  • Yuichi Sato
  • Shuji Terai
  • 全て表示

23
13
開始ページ
2414
終了ページ
2423
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3748/wjg.v23.i13.2414

AIM: To define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus. METHODS: Our 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. RESULTS: In 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. CONCLUSION: Based on clinical and histological data, we identified criteria, which differentiated between EoE, sEoE and EoEM, and reflected a different pathogenesis between these esophageal EoGDs.

リンク情報
DOI
https://doi.org/10.3748/wjg.v23.i13.2414
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28428721
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385408
ID情報
  • DOI : 10.3748/wjg.v23.i13.2414
  • PubMed ID : 28428721
  • PubMed Central 記事ID : PMC5385408

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