Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2015; 21(27): 8433-8440
Published online Jul 21, 2015. doi: 10.3748/wjg.v21.i27.8433
Systematic review: Eosinophilic esophagitis in Asian countries
Yoshikazu Kinoshita, Norihisa Ishimura, Naoki Oshima, Shunji Ishihara
Yoshikazu Kinoshita, Norihisa Ishimura, Naoki Oshima, Shunji Ishihara, Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo 693-8501, Japan
Author contributions: Kinoshita Y designed the study; Kinoshita Y, Ishimura N and Ishihara S performed the systematic literature search; Ishimura N and Oshima N performed the statistical calculations; Kinoshita Y and Ishihara S wrote the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare concerning this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yoshikazu Kinoshita, MD, PhD, Professor, Chairman, Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 89-1, Enya, Izumo 693-8501, Shimane, Japan. kinosita@med.shimane-u.ac.jp
Telephone: +81-853-202190 Fax: +81-853-202187
Received: March 20, 2015
Peer-review started: March 21, 2015
First decision: April 23, 2015
Revised: May 12, 2015
Accepted: June 10, 2015
Published online: July 21, 2015
Processing time: 124 Days and 4.1 Hours
Abstract

AIM: To investigate the prevalence and the clinical characteristics of Asian patients with eosinophilic esophagitis.

METHODS: We conducted a systematic search of the PubMed and Web of Science databases for original studies, case series, and individual case reports of eosinophilic esophagitis in Asian countries published from January 1980 to January 2015. We found 66 and 80 articles in the PubMed and Web of Science databases, respectively; 24 duplicate articles were removed. After excluding animal studies, articles not written in English, and meeting abstracts, 25 articles containing 217 patients were selected for analysis.

RESULTS: Sample size-weighted mean values were determined for all pooled prevalence data and clinical characteristics. The mean age of the adult patients with eosinophilic esophagitis was approximately 50 years, and 73% of these patients were male. They frequently presented with allergic diseases including bronchial asthma, allergic rhinitis, food allergy, and atopic dermatitis. Bronchial asthma was the most frequent comorbid allergic disease, occurring in 24% of patients with eosinophilic esophagitis. Dysphagia was the primary symptom reported; 44% of the patients complained of dysphagia. Although laboratory blood tests are not adequately sensitive for an accurate diagnosis of eosinophilic esophagitis, endoscopic examinations revealed abnormal findings typical of this disease, including longitudinal furrows and concentric rings, in 82% of the cases. One-third of the cases responded to proton pump inhibitor administration.

CONCLUSION: The characteristics of eosinophilic esophagitis in Asian patients were similar to those reported in Western patients, indicating that this disease displays a similar pathogenesis between Western and Asian patients.

Keywords: Eosinophilic esophagitis; Allergy; Prevalence; Symptom; Endoscopy; Asia; Treatment

Core tip: We conducted a systematic literature search of eosinophilic esophagitis in Asian countries. More than 200 patients with eosinophilic esophagitis were found, and their clinical characteristics were summarized. All clinical characteristics of the Asian patients, except for the prevalence of food impaction, were similar to those of Western patients. Eosinophilic esophagitis may share the same pathogenetic mechanisms between Asian and Western patients.