Gut Liver.  2016 Jan;10(1):37-41. 10.5009/gnl14269.

Clinicopathologic Analysis of Proton Pump Inhibitor-Responsive Esophageal Eosinophilia in Korean Patients

• Jung DH
• Yun GW
• Lee YJ
• Jo Y
• Park H

• KMID: 2382341
• DOI: http://doi.org/10.5009/gnl14269

Abstract

BACKGROUND/AIMS
Proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE) is a newly recognized form of eosinophilic esophagitis (EoE) that responds to PPI therapy. It remains unclear whether PPI-REE represents a subphenotype of gastroesophageal reflux disease, a subphenotype of EoE, or its own distinct entity. The aim was to evaluate the clinicopathologic features of PPI-REE.
METHODS
Six patients were diagnosed with PPI-REE based on symptoms, endoscopic abnormalities, esophageal eosinophilia with > or =15 eosinophils/high-power field, and a response to PPI treatment. Symptoms and endoscopic and pathological findings were evaluated.
RESULTS
The median follow-up duration was 12 months. Presenting symptoms included dysphagia, heartburn, chest pain, foreign body sensation, acid reflux, and sore throat. All patients had typical endoscopic findings of EoE such as esophageal rings, linear furrows, nodularity, and whitish plaques. Three patients had a concomitant allergic disorder, and one had reflux esophagitis. Four patients exhibited elevated serum IgE, and five had positive skin prick tests. All patients experienced symptomatic resolution within 4 weeks and histologic resolution within 8 weeks after starting PPI therapy. There was no symptomatic recurrence.
CONCLUSIONS
PPI therapy induced rapid resolution of symptoms and eosinophil counts in patients with PPI-REE. Large-scale studies with long-term follow-up are warranted.

Keyword

Proton pump inhibitor responsive esophageal eosinophilia; Eosinophilic esophagitis; Proton pump inhibitors

MeSH Terms

Adult
Asian Continental Ancestry Group
Chest Pain/etiology
Deglutition Disorders/etiology
Diagnosis, Differential
Eosinophilic Esophagitis/complications/*drug therapy/*pathology
Esophagus/pathology
Female
Follow-Up Studies
Gastroesophageal Reflux/etiology
Heartburn/etiology
Humans
Male
Middle Aged
Pharyngitis/etiology
Phenotype
Proton Pump Inhibitors/*therapeutic use
Republic of Korea
Retrospective Studies
Sensation Disorders/etiology
Treatment Outcome
Young Adult
Proton Pump Inhibitors