Specific locations of linear furrows in patients with esophageal eosinophilia

Objectives

Linear furrows are the most frequently found endoscopic abnormality in affected patients, however, the precise endoscopic features remain to be fully elucidated. Here, we aimed to clarify the endoscopic features of esophageal eosinophilia (EE), essential for diagnosis of EoE, by focusing on the specific locations of linear furrows in a Japanese population.

Methods

We enrolled 70 cases with EE (≥15 eosinophils/high power field) who were diagnosed at our hospital and related facilities. Information regarding endoscopic findings and clinical parameters was retrospectively reviewed. Next, the position of linear furrows in relation to esophageal longitudinal folds (ridge or valley) was evaluated in each case and compared with the position of mucosal breaks in patients with reflux esophagitis. Finally, the relationship between linear furrows and eosinophilic infiltration was evaluated.

Results

Of the 70 EE patients, 63 (90%) had linear furrows. Those occurred in a radial pattern and were widespread throughout the lower to upper esophagus, and exclusively found in esophageal longitudinal mucosal fold valleys, not on ridges, which was different from the position of mucosal breaks in patients with reflux esophagitis. Increased eosinophilic infiltration was significantly more frequent in linear furrows in the valleys (93%) as compared to mucosa on adjacent ridges (60%) (P < 0.05).

Conclusions

Investigation of these endoscopic characteristics, especially by focusing on linear furrows in esophageal mucosal fold valleys, may provide important clues for more accurate diagnosis of EoE. UMIN000018704.

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