嗜伊紅性食道炎

Eosinophilic Esophagitis

10.6314/JIMT.2012.23(5).04

江技坤(Chi-Kun Chiang)；蔡明杰(Ming-Chieh Tsai)；李嘉龍(Chia-Long Lee)；吳啟華(Chi-Hwa Wu)

嗜伊紅性食道炎 ； 吞嚥困難 ； 食物梗塞 ； 胃食道逆流疾病 ； Eosinophilic esophagitis, EoE ； Dysphagia ； Food impaction ； Gastroesophageal reflux disease

內科學誌

23卷5期（2012 / 10 / 01）

330 - 342

繁體中文

直到20年前，嗜伊紅性食道炎（Eosinophilic esophagitis）才被認為是一個獨立的疾病，這是一個經由過敏原引發的免疫相關、慢性及發炎性的疾病，在臨床上會表現出食道功能失調，如吞嚥困難、食物梗塞和胃食道逆流相關等症狀，病理學主要表現為食道上皮有明顯的嗜伊紅白血球浸潤（eosinophilic infiltration）。嗜伊紅性食道炎的盛行率和發生率正在逐年增加，兒童及成人都會發生，並且以男性病患居多。許多病患會合併有過敏相關疾患。診斷上需要綜合臨床表現和病理組織學才可判斷，並且要排除其他會造成食道嗜伊紅白血球增多的情形。治療上目前以局部類固醇為主流的第一線用藥，亦可考慮採飲食療法，針對嚴重食道狹窄的患者，可能需要進行食道擴張術。

Eosinophilic esophagitis (EoE) was not to be thought as a new entity of disease until two decades ago. This is an allergen triggered, immune-associated, chronic and inflammatory disease. Clinically, it presents with esophageal dysfunction, such as dysphasia, food impaction and symptoms related to gastroesophageal reflux disease. Pathologically, there is significant eosinophilic infiltration in the esophageal epithelium. The prevalence and incidence are increasing gradually. Both the children and adults are affected by EoE which predominantly occurs in male gender. And allergic diseases are also very common in patients with EoE. Both combination of the clinical features and histopathological findings and exclusion of other cause of esophageal eosinophilia are crucial before making the diagnosis. The topical steroid has been the mainstay of therapy presently. Diet therapy is also an alternative method. For patients with severe esophageal narrowing, esophageal dilation has to be considered.