2021 Volume 63 Issue 3 Pages 279-286
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease, clinically characterized by symptoms related to esophageal dysfunction and histologically characterized by eosinophil-predominant inflammation. In rare cases, there have been reports of subepithelial eosinophilic esophagitis or eosinophilic esophageal myositis, both of which are difficult to diagnose because the eosinophils are deeply infiltrated.
A 74-year-old male underwent esophagogastroduodenoscopy (EGD) to find the cause of dysphagia, but no abnormalities were observed. Although he started to take esomeprazole, his symptoms persisted. Six months later, he was hospitalized because of difficulty in oral feeding. EGD revealed mucosal cloudy edema around the middle and lower esophagus and a ring-shaped stenosis, which resulted in obstruction of passage. We suspected EoE by various examinations, but biopsies showed no eosinophil infiltration in the esophageal epithelium. Endoscopic ultrasound (EUS) showed thickening of the esophageal wall including the muscle layer. We diagnosed EoE with deep infiltration of eosinophils by repeated biopsies. We herein report a case of an EoE subtype in which severe obstruction of the esophagus occurred in six months and evaluation of the esophageal wall by EUS was useful for diagnosis.
