Epidemiology and Clinical Characteristics of Eosinophilic Esophagitis in Korea: Based on Single Center Endoscopic Database

Abstract

Background: Eosinophilic esophagitis (EoE) has been found to be one of the most common diseases among patients complaining of dysphagia and food impaction in western countries. Its epidemiology in Asia has not been clearly defined. We aimed to investigate the epidemiology and clinical characteristics of EoE in Korea using an endoscopic data base at a large tertiary care center. Methods: From January 2006 to October 2010, patients who underwent esophagogastroduodenoscopy (EGD) and esophageal biopsy at a tertiary center were identified. After review of slides by two well-experienced GI pathologists, the mean number of eosinophils (eos) per high power field (HPF) was counted using Olympus BX51 microscopy. Clinical data and endoscopic photographs were reviewed by an advanced esophagologist. Results: A total of 214438 patients underwent EGD. Among them, 6 patients (M:F=5:1, mean age= 44±13, mean eos/HPF:50.2±21.9) were found to have more than 15 eos/HPF and diagnosed with EoE. Two patients (M:F=1:1, mean eos/HPF: 12.5±0.7) showed borderline (514 eos/HPF) eosinophil infiltration. Indications for EGD in EoE patients were dyspepsia (n= 3), dysphagia (n=2) and food impaction (n=1). The endoscopic finding were feline (n= 4), speckled with white spots (n= 1), and normal (n= 1) esophagus. Two of 6 (33%) patients had a history of allergies. Conclusions: In spite of a rapidly growing number of EoE cases in western countries, the number of patients diagnosed with EoE in Korea is still remarkably low. Despite a gradual decrease in annual endoscopic volumes, the percent of patients in whom esophageal biopsies are collected has increased over the past 5 years; as has the number of patients diagnosed with EoE. Standardized, prospective data collection is needed to distinguish between the role of endoscopist awareness and hence, the frequency with which esophageal biopsies are collected, compared to the role of epidemiologic risk factors on the prevalence of EoE in Asia. Trend of Diagnosis of Eosinophilic Esophagitis (EoE)