{"id":1852,"date":"2007-10-01T01:00:00","date_gmt":"2007-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/oesophagite-a-eosinophiles-y-penser-chez-ladulte\/"},"modified":"2018-10-20T18:39:48","modified_gmt":"2018-10-20T16:39:48","slug":"oesophagite-a-eosinophiles-y-penser-chez-ladulte","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/oesophagite-a-eosinophiles-y-penser-chez-ladulte\/","title":{"rendered":"Oesophagite \u00e0 \u00e9osinophiles : y penser chez l\u2019adulte !!"},"content":{"rendered":"

2007<\/strong><\/p>\n

Danisi C (1), Poujol A (2), Charton-Bain MC (3), Picon-Coste M (1)
\n(1) Service de Gastroent\u00e9rologie ; CHG du Pays d\u2019Aix
\n(2) Service de P\u00e9diatrie; CHG du Pays d\u2019Aix
\n(3) Service d\u2019anatomopathologie; CHG du Pays d\u2019Aix<\/em><\/p>\n

Gastroent\u00e9rologie <\/strong>– \u00a02007-09-01 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

L’oesophagite \u00e0 \u00e9osinophiles (OE) est une entit\u00e9 anatomo-pathologique surtout d\u00e9crite en
\np\u00e9diatrie. N\u00e9anmoins, elle doit \u00eatre connue des gastroent\u00e9rologues, car cette pathologie peut se
\nr\u00e9v\u00e9ler chez l’adulte. Nous rapportons 4 observations d’OE diagnostiqu\u00e9es \u00e0 l\u2019H\u00f4pital d\u2019Aix et
\nfaisons le point sur la pr\u00e9sentation clinique, les moyens diagnostiques, les traitements propos\u00e9s
\net l\u2019\u00e9volution chez des adultes.<\/p>\n

OBSERVATIONS
\nCas 1 :
\nMr Dur N, n\u00e9 en 1988, hospitalis\u00e9 pour impaction alimentaire.
\nCas 2 :
\nMr Tor J, n\u00e9 en 1986, hospitalis\u00e9 pour h\u00e9mat\u00e9m\u00e8se sur corps \u00e9tranger oesophagien.
\nCas 3 :
\nMr Mar B, n\u00e9 en 1968, hospitalis\u00e9 pour dysphagie \u00e9voluant depuis 2 ans.
\nCas 4 :
\nMme Gla I, n\u00e9e en 1968, hospitalis\u00e9e pour dyspn\u00e9e aigue secondaire \u00e0 un corps \u00e9tranger intratrach\u00e9al
\net fausses routes fr\u00e9quentes.
\nDISCUSSION
\nL\u2019 OE, – bien connue des p\u00e9diatres – m\u00e9rite d\u2019\u00eatre connue des gastroent\u00e9rologues car de plus en
\nplus de cas sont rapport\u00e9s chez l\u2019adulte jeune.
\n\u00d8 La pr\u00e9dominance masculine semble \u00eatre v\u00e9rifi\u00e9e chez l\u2019adulte (3\/4 pour nos observations).
\n\u00d8 Le terrain atopique est fr\u00e9quent (1\/2 des cas).
\n\u00d8 La symptomatologie est souvent ancienne et inexpliqu\u00e9e : \u00e9pisodes aigus de dysphagie voire
\nblocages alimentaires ou dysphagie progressive, douleurs thoraciques avec bilan cardiaque
\nnormal.
\n\u00d8 Le diagnostic est fait parfois devant l\u2019aspect endoscopique (granulations blanch\u00e2tres, sillons
\nlongitudinaux, aspect en anneaux ou cr\u00e9nel\u00e9, parfois st\u00e9noses) et confirm\u00e9 par les biopsies de
\nl’oesophage (\u00e0 faire au niveau de l\u2019oesophage sup\u00e9rieur, moyen et inf\u00e9rieur). La population
\nd\u2019\u00e9osinophiles est sup\u00e9rieure \u00e0 20 \u00e9osinophiles\/champ. Il faut savoir qu\u2019une infiltration \u00e0
\n\u00e9osinophiles est souvent pr\u00e9sente lors du reflux gastro-oesophagien, mais localis\u00e9e seulement au
\ntiers inf\u00e9rieur de l\u2019oesophage et souvent moins dense.
\n\u00d8 La manom\u00e9trie est souvent faite devant la symptomatologie de troubles moteurs et est
\nsouvent normale. Lorsqu\u2019il existe des anomalies motrices (\u00e0 type d\u2019hyper contractilit\u00e9 ou \u00e0
\nab XVes Journ\u00e9es Nationales de l’ANGH Porquerolles 2007
\nl\u2019inverse d\u2019hypo motilit\u00e9), celles-ci sont la cons\u00e9quence de l\u2019infiltration oesophagienne, et elles
\nr\u00e9gressent sous traitement.
\n\u00d8 L\u2019\u00e9cho-endoscopie n\u2019est pas encore \u00e9valu\u00e9e dans cette pathologie.
\n\u00d8 Le traitement : cortico\u00efdes inhal\u00e9s (\u00e0 d\u00e9glutir) plus rarement par voie g\u00e9n\u00e9rale,
\nantileucotri\u00e8nes, dilatation des st\u00e9noses.
\n\u00d8 L\u2019\u00e9volution : le traitement reste empirique; 6 semaines de cortico\u00efdes d\u00e9glutis permettrait
\nl’absence de r\u00e9cidive; cependant aucune \u00e9tude contr\u00f4l\u00e9e chez l’enfant et l’adulte n’existe.<\/p>\n

CONCLUSION<\/p>\n

L\u2019OE est une nouvelle entit\u00e9 anatomo-clinique. Il faut y penser chez l\u2019adulte devant toute
\ndysphagie, et pratiquer des biopsies oesophagiennes \u00e9tag\u00e9es syst\u00e9matiques, qui porteront le
\ndiagnostic devant l\u2019infiltration \u00e0 \u00e9osinophiles du corps de l\u2019oesophage. La physiopathologie
\n\u00e9voque un probable ph\u00e9nom\u00e8ne allergique: \u00ab\u00a0asthme oesophagien\u00a0\u00bb. Le traitement est simple,
\nbas\u00e9 sur des cortico\u00efdes d\u00e9glutis, mais dont l’efficacit\u00e9 \u00e0 long terme reste \u00e0 d\u00e9finir<\/p>\n

BIBLIOGRAPHIE
\n– Charton-Bain MC, Poujol A, Danisi C, Sault MC. L\u2019oesophagite \u00e0 \u00e9osinophiles : une
\nnouvelle entit\u00e9 anatomo-clinique : \u00e0 propos de 4 cas de pr\u00e9sentation p\u00e9diatrique. Ann
\nPatho 2006 ; 26 :1S135.
\n– Lamouliatte H, Message L, Zerbib F. L\u2019oesophagite \u00e0 \u00e9osinophile de l\u2019adulte : une entit\u00e9
\n\u00e9mergente. Poster pr\u00e9sent\u00e9 aux JFPD 2005.
\n– Mishra A, Hogan SP, Brandt EB, Rothenberg ME. An etiological role for aeroallergens and
\noesinophils in experimental oesophagitis. J Clin Invest; 2001 Jan; 107 (1): 83-90
\n– Remedios M, Campbell C, Jones DM, Kerlin P. Eosinophilic oesophagitis in adults: clinical,
\nendoscopic, histologic findings, and response to treatment with fluticasone propionate.
\nGastrointest Endosc; 2006 Jan; 63 (1): 3-12
\n– Lucendo AJ, Castillo P, Martin-Chavarri S, Carrion G, Pajares R, Pascual JM, Mancenido N,
\nErdozian JC. Manometric findings in adult eosinophilic eosophagitis: a study of 12 cases.
\nEur J Gastroenterol Hepatol; 2007 May; 19 (5): 417-24
\nANGH Copyright 2007<\/p>\n","protected":false},"excerpt":{"rendered":"

2007 Danisi C (1), Poujol A (2), Charton-Bain MC (3), Picon-Coste M (1) (1) Service de Gastroent\u00e9rologie ; CHG du Pays d\u2019Aix (2) Service de P\u00e9diatrie; CHG du Pays d\u2019Aix (3) Service d\u2019anatomopathologie; CHG du Pays d\u2019Aix Gastroent\u00e9rologie – \u00a02007-09-01 –\u00a0CO – ________________________________ L’oesophagite \u00e0 \u00e9osinophiles (OE) est une entit\u00e9 anatomo-pathologique surtout d\u00e9crite en p\u00e9diatrie. […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[18],"class_list":["post-1852","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-18"],"yoast_head":"\nOesophagite \u00e0 \u00e9osinophiles : y penser chez l\u2019adulte !! - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/oesophagite-a-eosinophiles-y-penser-chez-ladulte\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Oesophagite \u00e0 \u00e9osinophiles : y penser chez l\u2019adulte !! 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