2019 Volume 61 Issue 7 Pages 1395-1400
The case was a 46-year-old female. Screening upper gastrointestinal endoscopy revealed discolored mucosa localized to the lower esophagus. An intraepithelial neoplasia was suspected, and she was referred to our hospital for close examination. Since the previous doctor detected eosinophilic infiltration by biopsy, we considered the possibility of eosinophilic esophagitis and started administration of esomeprazole. Eight weeks later, endoscopy showed that multiple discolored lesions in the mucosa and longitudinal grooves had spread over the area from the upper esophagus to the lower esophagus, resulting in the diagnosis of eosinophilic esophagitis. In recent years, the concept of localized eosinophilic esophagitis in the lower esophagus has been proposed and the possibility that eosinophilic esophagitis is an early form of esophageal eosinophilic inflammation has been pointed out. The endoscopic findings at the time of the screening endoscopic examination suggested localized lower esophageal eosinophilic inflammation. In this case, we were able to observe the natural course of diffusely spreading esophageal eosinophilic inflammation in the lower esophagus.
