scholarly journals Eosinophilic Vulvar Leukoderma

2021 ◽  
pp. 58-61
Author(s):  
Kaya Nakada ◽  
Shiro Niiyama ◽  
Toshiaki Oharaseki ◽  
Hidetsugu Fukuda
Keyword(s):  
Atopic Dermatitis ◽  
Eosinophilic Esophagitis ◽  
Histologic Examination ◽  
White Spot ◽  
Esophageal Disease ◽  
Esophageal Dysfunction

We report the case of a 54-year-old woman with asthma and atopic dermatitis who presented a white spot on the genitalia. Histologic examination showed numerous eosinophils in the epithelium and the dermis. Eosinophilic esophagitis is defined as an esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by an eosinophil-predominant inflammation. We discuss the possible relationship between the two diseases.

scholarly journals Transcriptomic Analysis Links Eosinophilic Esophagitis and Atopic Dermatitis

2019 ◽  
Vol 7 ◽  
Author(s):  
Rémi Doucet-Ladevèze ◽  
Sébastien Holvoet ◽  
Frédéric Raymond ◽  
Francis Foata ◽  
Gurjit K. Khurana Hershey ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Eosinophilic Esophagitis ◽  
Transcriptomic Analysis

High Incidence of Pulmonary Symptoms in Infants Evaluated for Esophageal Disease

1980 ◽  
Vol 89 (5) ◽  
pp. 450-453 ◽  
Author(s):  
Fred C. Rothstein ◽  
Thomas C. Halpin
Keyword(s):  
Acid Reflux ◽  
Endoscopic Examination ◽  
Esophageal Disease ◽  
Gastrointestinal Series ◽  
Rigorous Testing ◽  
High Incidence ◽  
Histologic Evaluation ◽  
Life Threatening ◽  
Esophageal Dysfunction ◽  
Upper Gastrointestinal

Of 62 children (1–24 months of age) evaluated for esophageal disease, 22 were found to have pulmonary symptoms of apnea, pneumonia, wheezing, cyanosis, cough and stridor. Upper gastrointestinal series showed free gastroesophageal reflux in 10 of 22 infants; 3 were thought to have stricture. Acid-reflux test was positive in 13 of 15 and correlated with the presence of esophagitis in 12. In addition to esophagitis, endoscopic examination found two foreign bodies and an esophageal stricture unrecognized during fluoroscopy. Endoscopic grasp biopsy was inadequate in most infants for the histologic evaluation of esophagitis. However, suction biopsy correlated well with endoscopically diagnosed esophagitis. In infants where medical therapy failed and symptoms were life-threatening, a Nissen fundoplication resulted in excellent resolution of symptoms. In children who present with prolonged and often life-threatening symptoms, esophageal dysfunction should be evaluated by rigorous testing.

scholarly journals Eosinophilic esophagitis and allergic rhinitis with sensitization to indoor allergens as a comorbid diseases

2016 ◽  
Vol 13 (2) ◽  
pp. 19-22
Author(s):  
I I Vorzheva ◽  
V G Neustroev ◽  
L Y Raevskaya ◽  
B A Chernyak
Keyword(s):  
Allergic Rhinitis ◽  
Eosinophilic Esophagitis ◽  
Clinical Case ◽  
House Dust Mites ◽  
Dust Mites ◽  
Eosinophilic Inflammation ◽  
Indoor Allergens ◽  
Pollen Allergens ◽  
Persistent Allergic Rhinitis ◽  
Esophageal Dysfunction

Eosinophilic esophagitis (EE) is a chronic disease characterized by antigen-mediated eosinophilic inflammation leading to esophageal dysfunction. Food and pollen allergens are considered to be the main cause of EE. Indoor allergens can offend EE but not so often as food and pollen. Clinical case of EE associated with persistent allergic rhinitis with sensitization to house dust mites and cockroaches is presented in the article. Successful treatment with inhaled topical corticosteroids, taken orally, confirmed by endoscopy and biopsy is demonstrated.

Clinical management of eosinophilic esophagitis – a nationwide survey among gastroenterologists in Germany

2019 ◽  
Vol 57 (06) ◽  
pp. 745-752 ◽  
Author(s):  
Stephan Miehlke ◽  
Ulrike von Arnim ◽  
Christoph Schlag ◽  
Thomas Frieling ◽  
Ahmed Madisch ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Clinical Management ◽  
Elimination Diet ◽  
Esophageal Disease ◽  
Dietary Therapy ◽  
High Dose ◽  
Topical Steroids ◽  
Allergy Test ◽  
Long Term Treatment ◽  
Food Elimination

Abstract Background Eosinophilic esophagitis (EoE) is an increasingly recognized immune-mediated esophageal disease and a common cause for dysphagia and food bolus obstruction. The aim of this study was to evaluate the current clinical management of EoE among adult gastroenterologists in Germany. Methods We performed a cross-sectional study of 1393 adult gastroenterologists using a questionnaire containing 22 questions to general, diagnostic, and therapeutic aspects of EoE. The self-administered online survey was conducted between November 2017 and February 2018. Data capture and analysis was performed using SurveyMonkey. Results The overall responder rate was 29.6 %. More than half of the responders (54.9 %) felt to observe a significant increase of EoE patients. The EREFS score was mostly either unknown (44.3 %) or not routinely used (52.2 %). If EoE was suspected, most responders obtained multiple esophageal biopsies (n = 3 – 4: 35.7 %; n > 4: 61.6 %). The preferred primary treatment was proton pump inhibitors (PPI) in 37.2 % and topical steroids in 35.0 % of responders. PPI regimens were highly diverse, with only half of responders using high-dose PPI regimens. Allergy testing was often initiated (always 25.4 %, sometimes 48.9 %). The most common dietary therapy was 6-food elimination diet (52 %), followed by allergy test-directed diets (16 %) and 2-food elimination diet (16.5 %). The majority of responders indicated a need for long-term treatment (i. e., 23 % of responders in > 50 % their patients and 47.7 % of responders in 25 – 50 % of their patients). Conclusions Among gastroenterologists in Germany, substantial variation in the adherence to published EoE guidelines appears to exist. This indicates the need for intensified education and national guidelines in order to optimize and harmonize the clinical management of EoE patients.

173 CATERPILLAR SIGN: NOVEL ENDOSCOPIC FINDING IN PATIENTS WITH EOSINOPHILIC ESOPHAGITIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Maki Ayaki ◽  
Noriaki Manabe ◽  
Ken Haruma ◽  
Jun Nakamura ◽  
Minoru Fujita ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Eosinophilic Esophagitis ◽  
Definitive Diagnosis ◽  
Clinicopathological Features ◽  
Endoscopic Finding ◽  
Eosinophil Infiltration ◽  
High Power Field ◽  
Endoscopic Findings ◽  
Esophageal Dysfunction

Abstract   Pathological identification of esophageal eosinophilia (EE) is considered to be most important and critical step for diagnosis of eosinophilic esophagitis (EoE). Although several endoscopic findings related with EoE have been reported, it is still difficult to exclude other causes of EE, such as gastroesophageal reflux disease. Here, we noted a novel endoscopic finding related with EoE termed ‘Caterpillar sign’. The aim of this study was to evaluate its clinical significance for the diagnosis of EoE. Methods One hundred and seventy-four patients who were endoscopically suspected with EoE at our hospital and affiliated institutions were enrolled. EoE was defined clinically by symptoms of esophageal dysfunction and histologically by the presence of EE [≧15 eosinophils/high power field (HPF)]. Endoscopic findings at baseline were retrospectively reviewed. ‘Caterpillar sign’ was defined as a stair-like, fragile, slight mucosal protruded lesion sandwiched between longitudinal furrows, such as the Caterpillar traces remaining on the ground (Figure). Furthermore, the clinicopathological features of patients having ‘Caterpillar sign’ were evaluated. Results One hundred and seventy-four patients (92 males, 82 females with mean age of 49.7) suspected with EoE were evaluated, of whom 60 (34.5%) was finally diagnosed as EoE. ‘Caterpillar sign’ was found in 48 patients (80.0%). Sensitivity and Specificity of ‘Caterpillar sign’ for the diagnosis of EoE was 0.80 (95% confidence interval [CI] 0.72–0.85) and 0.94 (95% CI 0.90–0.97), respectively. Furthermore, the presence of ‘Caterpillar sign’ was associated with degree of eosinophil infiltration (Caterpillar sign positive: 42.9 ± 49.3/HPF vs. Caterpillar sign negative: 6.7 ± 24.4/HPF, p < 0.0001). Conclusion This novel finding termed ‘Caterpillar sign’ was clinically useful for the definitive diagnosis of EoE and associated with degree of eosinophil infiltration.

scholarly journals Clinical relevance of esophageal subepithelial activity in eosinophilic esophagitis

2019 ◽  
Vol 55 (3) ◽  
pp. 249-260 ◽  
Author(s):  
Ikuo Hirano
Keyword(s):  
Disease Severity ◽  
Eosinophilic Esophagitis ◽  
Clinical Care ◽  
Topical Steroid ◽  
Muscularis Propria ◽  
Therapeutic Interventions ◽  
Stricture Formation ◽  
Complete Evaluation ◽  
Impedance Planimetry ◽  
Esophageal Dysfunction

Abstract Esophageal subepithelial activity (ESEA) is an important determinant of disease severity and complications in eosinophilic esophagitis (EoE). Inflammation and fibrosis of the lamina propria and muscularis propria result in esophageal dysfunction and stricture formation that are clinically manifest by symptoms of dysphagia and food impaction as well as the need for esophageal dilation. Esophageal biopsies that are limited to the evaluation of the esophageal epithelium are an inadequate means to assess overall, clinical disease severity in EoE. Instruments for the assessment of subepithelial activity in EoE are both limited and/or underutilized and thus represent an important unmet clinical need. Studies using endoscopic features, endoscopic ultrasonography, and barium esophagography have demonstrated improvement in ESEA parameters with topical steroid therapy. Impedance planimetry is being evaluated as an objective and quantifiable measure of esophageal distensibility that is a consequence of ESEA. In conjunction with symptom and histologic assessment, evaluation of ESEA provides a more complete evaluation of disease activity in EoE that will enhance clinical care as well as provide insights into the strengths and limitations of therapeutic interventions.

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