Two Japanese patients with esophageal eosinophilia detected by routine medical examination

Eosinophilic esophagitis (EoE) is rarely diagnosed condition involving eosinophilic infiltration of the esophageal mucosa. EoE in adults has been increasingly recognized and actively investigated in Western countries, but few cases have been reported in Asian populations. Herein, we report two Japanese cases of esophageal eosinophilia detected by routine medical examination. One patient had heartburn, and endoscopy of the esophagus showed whitish elevated lesions resembling papillomas and persistent concentric rings. Esophageal biopsies confirmed esophageal eosinophilia and EoE was diagnosed. The patient’s condition improved with proton pump inhibitor treatment followed by topical steroid therapy. The other patient was asymptomatic, but endoscopy revealed white exudates, and esophageal eosinophilia was confirmed by histology. Eosinophilia in this patient resolved with conservative treatment. These experiences suggest that both symptomatic and asymptomatic patients with esophageal eosinophilia, including EoE, may be increasingly detected in Asian countries.