健診で発見される好酸球性食道炎の特徴と予後

Clinical Features and Prognosis of Eosinophilic Esophagitis Cases Diagnosed by Upper GI Endoscopic Screening

要旨●健診目的の内視鏡検査7,587例中36例（0.47％）が好酸球性食道炎と診断された．男性32例，女性4例で，40歳代で最も多くみられたが，発見頻度では39歳以下も高かった．29例（80.6％）がアレルギー疾患を有し，つかえ感，胸やけなどの症状を25例（69.4％）に認めた．過去の内視鏡像の検討では，25例中12例（48.0％）に好酸球性食道炎を疑う内視鏡所見を以前から認めていた．PPI反応性を検討した30例中23例（76.7％）はPPI-REEであり，7例が狭義の好酸球性食道炎であった．PPI-REEにおいてPPI中止後は高頻度に再燃を認めた．

　Among 7,587 cases who were screened by upper GI endoscopic examination, thirty-six were diagnosed with eosinophilic esophagitis. Thus, its prevalence was 0.47%, and there were 32 and 4 male and female cases, respectively. Twenty-nine cases（81%）had some allergic disease, and 25（69%）had some upper GI symptoms, such as dysphagia and heartburn. Twelve of these 25 cases（48%）had shown some endoscopic findings of eosinophilic esophagitis in previous endoscopic examinations. Twenty-three of 30 cases（77%）were considered to be PPI（proton-pump inhibitor）-responsive esophageal eosinophilia（PPI-REE）, and the other 7 cases were diagnosed as EE in the narrow sense. Disease recurrence was frequently observed after cessation of PPI administration in cases with PPI-REE.