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World J Gastroenterol. 2015 Jul 21;21(27):8433-40. doi: 10.3748/wjg.v21.i27.8433.

Systematic review: Eosinophilic esophagitis in Asian countries.

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Yoshikazu Kinoshita, Norihisa Ishimura, Naoki Oshima, Shunji Ishihara, Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo 693-8501, Japan.



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


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.


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.


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.


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

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