Abstract
Background and study aims Endoscopic findings of esophageal eosinophilia sometimes localize to small areas
of the esophagus. A previous study suggested that pathogenesis of localized-type eosinophilic
esophagitis (LEoE) was associated with acid reflux. However, LEoE treatment outcomes
have not been studied. We aimed to analyze the clinical and histologic significance
of LEoE in comparison with diffuse-type eosinophilic esophagitis (DEoE).
Patients and methods This study included 106 patients with esophageal eosinophilia. Esophageal eosinophilia
was defined as a condition where the maximum number of intraepithelial eosinophils
was ≥ 15 per high-power field. LEoE was defined as an endoscopic lesion confined to
one-third of the esophagus: upper, middle, or lower. Esophageal eosinophilia encompassing
more than two-thirds of the esophagus was defined as DEoE. We retrospectively compared
LEoE and DEoE in terms of clinical characteristics, histologic findings, and proportion
of proton pump inhibitor (PPI) responders.
Results Of 106 patients, 12 were classified as having LEoE and 94 were classified as having
DEoE. The proportion of asymptomatic patients was significantly higher in the LEoE
group than the DEoE group (42 % vs 7 %, P < 0.01). In the LEoE group, 10 patients (84 %) had endoscopic lesions in the lower
esophagus. The maximum number of eosinophils did not differ between the groups (54
[24 – 71] for LEoE, 40 [20 – 75] for DEoE, P = 0.65). The prevalence of PPI responders was significantly higher in the LEoE group
than the DEoE group (100 % vs 63 %, P = 0.01).
Conclusion LEoE can be a sign of good responsiveness to PPI therapy.
