Reversibility of Endoscopic Features after Treatment for Eosinophilic Esophagitis

다국어 초록 (Multilingual Abstract)

Purpose: The prevalence and incidence of eosinophilic esophagitis (EoE) are increasing worldwide. Despite increased understandingof inflammatory pathogenesis, changes in endoscopic features after treatment of EoE have not been clearly described.
We aimed to investigate the reversibility of endoscopic features of EoE after treatment.
Materials and Methods: Out of 58 adult subjects who were diagnosed with EoE at the Yonsei University Health System from July2006 to August 2019, we recruited 33 subjects (30 males; mean age: 42 years) whose pre-treatment and post-treatment endoscopicimages were available. Endoscopic features included both inflammatory and fibrostenotic features. Exudate, edema, furrow,and crepe paper-like mucosa were classified as inflammatory features. Ring and stricture were classified as fibrostenotic features.
We compared changes in endoscopic features after treatment for EoE.
Results: After treatment, clinical symptoms improved in all patients. The following endoscopic features were observed beforetreatment: furrow (81.8%), edema (90.9%), exudate (42.4%), ring (27.3%), crepe paper-like mucosa (15.2%), and stricture (3.0%).
Endoscopic remission was achieved in 21 patients (63.6%). Inflammatory features were reversible (72.7%, p<0.001), whereas fibrostenoticfeatures were not (10%, p=0.160). Exudate had resolved in 92.9% of patients, edema in 70% and furrow in 88.9%. Ring andstricture persisted in almost all of the patients (9/10) who had these endoscopic features before treatment.
Conclusion: We outlined the reversibility of endoscopic inflammatory features of EoE. Fibrostenotic features were irreversible afteresophageal remodeling in patients with EoE. However, further validation studies with long-term follow-up are needed.

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