[Clinical implications of endoscopically suspected eosinophilic esophagitis]

We aimed to determine the concordance rate and clinical predictors of eosinophilic esophagitis (EoE) in patients with endoscopically suspected eosinophilic esophagitis (ESEoE) findings.

From June 2006 to December 2009 in Gangnam Severance Hospital, we prospectively enrolled the patients of "endoscopically suspected eosinophilic esophagitis (ESEoE)", and then we retrospectively reviewed and analyzed clinical features and endoscopic findings.

We found 17 patients of ESEoE, and 5 of them were finally confirmed as an EoE by histology (diagnostic concordance rate 29.4%). We added two more patients previously diagnosed as EoE and compared patients of EoE＋ (n=7) with EoE- (n=12). Mean age was 56.0 (range 36-70) and 51.0 (range 36-68) years old, respectively. In EoE＋ group, there were 5 males and 2 females and 6 males and 6 females in EoE- group. The symptoms of EoE＋ patients were dysphagia (n=5), food impaction (n=3), foreign body sensation in esophagus (n=2), chest pain (n=1), and heartburn (n=1). EoE- patients complained food impaction (n=5), heartburn (n=4), chest pain (n=2), foreign body sensation in esophagus (n=2), and dysphagia (n=1). The endoscopic findings of EoE＋ patients were furrows (n=6), rings (n=5), exudates or nodules (n=3), and friability (n=1). EoE- patients showed rings (n=10) and furrows(n=7). Univariative analysis showed that 'a symptom of dysphagia', 'presence of exudates or nodules', 'more than 2 suggestive endoscopic findings' were significantly different between two groups.

In ESEoE, diagnostic concordance rate was 29.4%. In addition, 'symptom of dysphagia', 'exudates or nodules', '≥ endoscopic findings' are more suggestive of EoE in ESEoE patients.