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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(12): E1817-E1825
DOI: 10.1055/a-1268-7312
Original article

Endoscopic findings of gastric lesions in patients with eosinophilic gastrointestinal disorders

Yasuhiro Fujiwara
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Kojiro Tanoue
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Akira Higashimori
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Yu Nishida
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Masatsugu Maruyama
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Shigehiro Itani
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Masaki Ominami
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Yuji Nadatani
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
2   Department of Premier Preventive Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Shusei Fukunaga
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Koji Otani
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Shuhei Hosomi
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Fumio Tanaka
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Noriko Kamata
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Yasuaki Nagami
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Koichi Taira
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Hirohisa Machida
3   Department of Internal Medicine, Machida Gastrointestinal Hospital, Osaka, Japan
,
Tetsuya Tanigawa
4   Department of Gastroenterology, Osaka City Juso Hospital, Osaka, Japan
,
Toshio Watanabe
1   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Masahiko Ohsawa
5   Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
F-Study group › Author Affiliations
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Abstract

Background and study aims Eosinophilic gastrointestinal disorders are classified into eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, and eosinophilic colitis according to the site of eosinophilic infiltration. Although well established in eosinophilic esophagitis, endoscopic findings in eosinophilic gastritis and eosinophilic gastroenteritis with regard to gastric lesions have not been clearly described. The aim of this study was to identify endoscopic findings of gastric lesions associated with eosinophilic gastrointestinal disorders.

Patients and methods Out of 278 patients with eosinophilic gastrointestinal disorders, 18 had eosinophilic gastritis or eosinophilic gastroenteritis confirmed by biopsy; their endoscopic images were analyzed retrospectively. The association between endoscopic findings and number of eosinophils in the gastric mucosa was investigated.

Results Erythema was most frequently observed (72 %), followed by ulcers (39 %), discoloration (33 %), erosions (28 %), nodularity (28 %), and polyps (28 %). There were several unique endoscopic findings such as submucosal tumor-like deep large ulcers in three patients, antral Penthorum-like appearances (small nodules radially lined toward the pyloric ring) in three patients, “muskmelon-like appearances” (discolored mucosa-composed mesh pattern) in three patients, multiple white granular elevations in two patients, cracks (appearance of furrows similar to those in eosinophilic esophagitis) in five patients, and antral rings in one patient. No significant association was observed between endoscopic findings and number of gastric eosinophils.

Conclusions Several unique endoscopic findings of gastric lesions were observed in patients with eosinophilic gastritis or eosinophilic gastroenteritis. Submucosal tumor-like ulcers, antral Penthorum-like appearances, muskmelon-like appearances, and cracks might be associated with eosinophilic gastrointestinal disorders.



Publication History

Received: 17 June 2020

Accepted: 03 September 2020

Article published online:
17 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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