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A Japanese case of eosinophilic esophagitis

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Abstract

Eosinophilic esophagitis (EE) is a rarely diagnosed condition involving eosinophilic infiltration of the esophageal mucosa. Here we present a case of EE in a 69-year-old Japanese man, who presented with abdominal pain, appetite loss, and a history of bronchial asthma. Laboratory findings included peripheral eosinophilia and an increased serum immunoglobulin E level. Computed tomography showed diffuse severe thickening of the esophageal wall, and a barium esophagogram revealed a small caliber of the middle and lower portion of the esophagus, without normal peristaltic contractions. Endoscopy of the esophagus showed a pale mucosa, with adherent whitish exudates resembling fungal infection, and prominent ring-like contractions. Histologic examination of a biopsy specimen revealed marked eosinophil infiltration into the esophageal mucosa. Endoscopic ultrasonography (EUS) demonstrated marked circumferential thickening of the esophageal submucosal layer, and an esophageal manometry study showed a high percentage of ineffective esophageal peristalsis and high-amplitude esophageal body contractions. EUS findings showed no change even after oral corticosteroid therapy, although the histological findings were improved. This is thought to be the first documented Japanese case of EE. EE should be considered in the differential diagnosis in cases of esophageal motility disturbance, even if the patients do not complain of dysphagia.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan

    Koichiro Furuta, Kyoichi Adachi, Kentaro Kowari, Yuko Mishima, Hiroshi Imaoka, Chikara Kadota, Kenji Koshino, Yasunori Kadowaki, Kenji Furuta, Hideaki Kazumori, Shuichi Sato, Shunji Ishihara & Yoshikazu Kinoshita

  2. Division of Gastrointestinal Endoscopy, Shimane University Hospital, Izumo, Japan

    Tatsuya Miyake & Yuji Amano

  3. Honda Medical Clinic, Izumo, Japan

    Masaaki Honda

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  1. Koichiro Furuta
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  2. Kyoichi Adachi
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Furuta, K., Adachi, K., Kowari, K. et al. A Japanese case of eosinophilic esophagitis. J Gastroenterol 41, 706–710 (2006). https://doi.org/10.1007/s00535-006-1827-9

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  • DOI: https://doi.org/10.1007/s00535-006-1827-9

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