胃と腸53巻3号

2018年03月発行

今月の主題 好酸球性食道炎の診断と治療 主題

好酸球性食道炎の疫学と診断基準

著者： 木下芳一¹ 石原俊治¹ 石村典久¹ 足立経一²

所属機関： ¹島根大学医学部内科学講座第二 ²島根県環境保健公社総合健診センター

ページ範囲：P.262 - P.270

要旨●好酸球性食道炎は環境因子が大きく関与して発症する，食物抗原に対する慢性的なアレルギー疾患である．他のアレルギー疾患と同様に，疾患概念が1990年代に確立してから欧米を中心に急増しており，本邦においても増加傾向がみられる．30〜50歳代の若い男性に多い．海外ではさまざまなコンセンサスレポートや診療ガイドラインが作成されているが，疾患の理解が進むとともに改定が繰り返されている．本邦でも厚生労働省の研究班が2015年に診断指針を改定している．食道に起因する症状の存在と食道粘膜上皮層中の多数の好酸球の存在が診断には必須とされており，プロトンポンプ阻害薬治療に対する抵抗性は必須ではない．本邦では症状が軽度な例が多く，内視鏡検査での特徴的な所見が診断のきっかけとなることが多い．

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