Document Detail


Eosinophilic esophagitis in adults: clinical, endoscopic, histologic findings, and response to treatment with fluticasone propionate.
MedLine Citation:
PMID:  16377308     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Eosinophilic esophagitis is an increasingly recognized disorder characterized by intense eosinophilic infiltration of the esophageal mucosa. The aim of this study was to define the clinical syndrome, the endoscopic features, and the distribution of the eosinophil infiltrate in adults with eosinophilic esophagitis. We undertook a prospective evaluation of the symptomatic and histologic response to treatment with fluticasone propionate. METHODS: Twenty-six patients (18 men; mean age 36 years) had symptom assessment and barium studies, esophageal motility recordings, and 24-hour esophageal pH studies. Upper-GI endoscopy was performed with quantitative eosinophil counts of biopsy specimens from the proximal and distal esophagus, the gastric antrum, and the duodenum. Nineteen subjects received 4 weeks of swallowed fluticasone propionate. After treatment, symptom assessment and endoscopic biopsies were repeated. RESULTS: All 26 patients had a history of dysphagia, and 11 presented acutely with food-bolus obstruction. Esophageal peristalsis was normal in most and gastroesophageal reflux coexisted in 10 patients. Characteristic endoscopic findings of furrows (20) and rings (18) were observed. All 19 treated patients had symptom improvement and a significant decrease in esophageal eosinophil counts. CONCLUSIONS: Eosinophilic esophagitis is a distinct entity that may coexist with gastroesophageal reflux. Swallowed fluticasone propionate is an effective treatment.
Authors:
Matthew Remedios; Catherine Campbell; Dianne M Jones; Paul Kerlin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  63     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-26     Completed Date:  2006-04-25     Revised Date:  2007-10-04    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-12     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / administration & dosage,  therapeutic use*
Adult
Androstadienes / administration & dosage,  therapeutic use*
Deglutition Disorders / etiology
Duodenum / pathology
Endoscopy, Gastrointestinal
Eosinophils / pathology
Esophagitis / drug therapy*,  pathology*,  physiopathology
Esophagus / pathology
Gastroesophageal Reflux / complications
Humans
Leukocyte Count
Male
Mucous Membrane / pathology
Prospective Studies
Pyloric Antrum / pathology
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Androstadienes; 90566-53-3/fluticasone
Comments/Corrections
Comment In:
Gastrointest Endosc. 2006 Jan;63(1):13-5   [PMID:  16377309 ]
Rev Gastroenterol Disord. 2006 Fall;6(4):245-7   [PMID:  17224897 ]

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