Mechanisms of AllergyIdiopathic eosinophilic esophagitis is associated with a TH2-type allergic inflammatory response☆,☆☆
Section snippets
Study population
Eight patients (7 men and 1 woman; mean age, 46.5 years; age range, 22-63 years) with clinically, endoscopically, and histologically diagnosed IEE were investigated (Table I). The average duration of the disease was 10.4 years. The only presenting symptom was acute recurrent dysphagia with food impaction. Gastroesophageal reflux disease was excluded by (1) a lack of clinical and histologic response to acid blockade, (2) normal pH probe monitoring of the distal esophagus, and (3) esophageal
Patients
The clinical features of the 8 patients with IEE and the 3 control patients are shown in Table I. Patients reported that the dysphagia events had lasted between 1 minute and 2 hours. The duration of the events varied considerably in most of the patients. Only patients 2, 5, and 7 had brief events (not exceeding 5 minutes). Most of the patients had had IEE for many years, suggesting that it is a chronic disease. Physical examination of all patients revealed no abnormalities. In 6 patients with
Discussion
Esophageal eosinophilia has been observed in several diseases, including reflux esophagitis,5 eosinophilic gastroenteritis,4 parasitic infection,13 and drug-induced reactions.14 These diseases must be ruled out before the diagnosis of IEE can be established. In agreement with previous reports,1, 2, 3 we note that IEE was mostly found in male individuals. The primary symptom of IEE is dysphagia. All of the patients in this study had exclusively esophageal symptoms with uniform attacks of
Acknowledgements
We thank Martina Weber for technical assistance, Dr Hanspeter Spichtin for biopsy specimens, and Dr Niklaus Schaub for suggestions and discussions.
References (23)
- et al.
Eosinophilic gastroenteritis with esophageal involvement
Gastroenterology
(1977) - et al.
T cells and T cell-derived cytokines as pathogenic factors in the nonallergic form of atopic dermatitis
J Invest Dermatol
(1999) - et al.
The spectrum of pediatric eosinophilic esophagitis beyond infancy: a clinical series of 30 children
Am J Gastroenterol
(2000) - et al.
Idiopathische Eosinophile Oesophagitis: Eine häufig verkannte Krankheit mit typischer Klinik und diskretem endoskopischem Bild
Schweiz Med Wochenschr
(1994) - et al.
Esophageal eosinophilia with dysphagia, a distinct clinicopathologic syndrome
Dig Dis Sci
(1993) - et al.
Idiopathic eosinophilic esophagitis
Radiology
(1993) - et al.
Intraepithelial eosinophils in endoscopic biopsies of adults with reflux esophagitis
Am J Surg Pathol
(1984) - et al.
Primary eosinophilic esophagitis in children: successful treatment with oral corticosteroids
J Pediatr Gastroenterol Nutr
(1997) - et al.
Treatment of eosinophilic esophagitis with inhaled corticosteroids
J Pediatr Gastroenterol Nutr
(1998) - et al.
Allergic esophagitis in children. A clinicopathological entity
Am J Surg Pathol
(1999)
Asthma
N Engl J Med
Cited by (506)
Transcriptomic profiling of the acute mucosal response to local food injections in adults with eosinophilic esophagitis
2024, Journal of Allergy and Clinical ImmunologyAssociations of Eosinophilic Gastrointestinal Disorders with Other Gastrointestinal and Allergic Diseases
2024, Immunology and Allergy Clinics of North AmericaHistopathology of Eosinophilic Esophagitis
2024, Immunology and Allergy Clinics of North AmericaAchalasia is Strongly Associated With Eosinophilic Esophagitis and Other Allergic Disorders
2024, Clinical Gastroenterology and HepatologyMast cells disrupt the function of the esophageal epithelial barrier
2023, Mucosal Immunology
- ☆
Supported by the Swiss National Science Foundation (grant no. 31-58916.99), AstraZeneca, Zug, and Essex Chemie AG, Lucerne, Switzerland.
- ☆☆
Reprint requests: Hans-Uwe Simon, MD, PhD, Department of Pharmacology, University Bern, Friedbühlstrasse 49, CH-3010 Bern, Switzerland.