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首页> 外文期刊>World Journal of Gastroenterology >Eosinophilic esophagitis: a newly established cause of dysphagia.
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Eosinophilic esophagitis: a newly established cause of dysphagia.

机译：嗜酸性食管炎：吞咽困难的新近确立原因。

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摘要

Eosinophilic esophagitis has rapidly become a recognized entity causing dysphagia in young adults. This review summarizes the current knowledge of eosinophilic esophagitis including the epidemiology, clinical presentation, diagnostic criteria, pathophysiology, treatment, and prognosis. An extensive search of PubMed/Medline (1966-December 2005) for available English literature in humans for eosinophilic esophagitis was completed. Appropriate articles listed in the bibliographies were also attained. The estimated incidence is 43/10(5) in children and 2.5/10(5) in adults. Clinically, patients have a long history of intermittent solid food dysphagia or food impaction. Some have a history of atopy. Subtle endoscopic features may be easily overlooked, including a "feline" or corrugated esophagus with fine rings, a diffusely narrowed esophagus that may have proximal strictures, the presence of linear furrows, adherent white plaques, or a friable (crepe paper) mucosa, prone to tearing with minimal contact. Although no pathologic consensus has been established, a histologic diagnosis is critical. The accepted criteria are a dense eosinophilic infiltrate (>20/high power field) within the superficial esophageal mucosa. In contrast, the esophagitis associated with acid reflux disease can also possess eosinophils but they are fewer in number. Once the diagnosis is established, treatment options may include specific food avoidance, topical corticosteroids, systemic corticosteroids, leukotriene inhibitors, or biologic treatment. The long-term prognosis of EE is uncertain; however available data suggests a benign, albeit inconvenient, course. With increasing recognition, this entity is taking its place as an established cause of solid food dysphagia.
机译：嗜酸性食管炎已迅速成为引起年轻人吞咽困难的公认病因。这篇综述总结了嗜酸性食管炎的当前知识，包括流行病学，临床表现，诊断标准，病理生理学，治疗和预后。在PubMed / Medline（1966年12月至2005年12月）的广泛搜索中，已完成了有关人类嗜酸性粒细胞性食管炎的英语文献的搜索。还获得了参考书目中列出的适当文章。儿童的估计发病率为43/10（5），成人为2.5 / 10（5）。临床上，患者长期存在间歇性固体食物吞咽困难或食物受累的病史。有些人患有特应性病史。细微的内窥镜特征可能容易被忽略，包括“猫科”或波纹状食管，带有细环，弥散性狭窄的食管，可能具有近端狭窄，线性沟，粘附的白斑或易碎（皱纹纸）粘膜，易发以最小的接触撕裂。尽管尚未建立病理学共识，但组织学诊断至关重要。公认的标准是浅表食管粘膜内有密集的嗜酸细胞浸润（> 20 /高倍视野）。相反，与酸倒流病相关的食道炎也可以具有嗜酸性粒细胞，但数量较少。一旦确定了诊断，治疗选择可能包括避免特定食物，局部使用皮质类固醇，全身性皮质类固醇，白三烯抑制剂或生物治疗。 EE的长期预后尚不确定；但是，现有数据表明这是一个良性的过程，尽管不方便。随着越来越多的认识，该实体已取代固体食物吞咽困难的既定原因。

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