小児における好酸球性消化管疾患の診断

Pediatric Eosinophilic Gastrointestinal Disorders in Japan;Diagnosis

要旨　本邦における小児の好酸球性消化管疾患（eosinophilic gastrointestinal disorders ; EGID）では，好酸球性食道炎の報告は少なく，好酸球性胃腸炎の報告が多い．また，アレルギーとの関連が注目されている．小児のEGIDは，内視鏡所見や病理所見では成人との共通点も多いが，年齢による変化は多彩である．小児の消化管内視鏡検査が十分に行える施設が限られていることからも，消化器症状を認めた小児において，本疾患群を疑い検索することは必ずしも容易ではない．本稿では，小児特有の病態も含め，小児のEGIDについて概説する．

　Primary EGID（eosinophilic gastrointestinal disorders）selectively affect the digestive tract with eosinophil-dominant inflammation, and are largely associated with allergic responses. The number of children with eosinophilic gastroenteritis is considerably greater than the number of children with eosinophilic esophagitis in Japan, unlike that noted in Western countries. There are a number of similarities in endoscopic and pathological findings between pediatric and adult patients with EGID. However, the presenting symptoms of pediatric EGID vary widely with age. Additionally, pediatric gastrointestinal endoscopy is available at a limited number of hospitals in Japan. Therefore, further work-up for pediatric patients with suspected EGID is not always easy. Here we review pediatric EGID, including the conditions specific to children.