Division of Digestive and Liver Disease, Columbia University Medical Center, New York, NY, USA.
J Clin Gastroenterol. 2012 Jan;46(1):e6-e11. doi: 10.1097/MCG.0b013e318221aefd.
GOALS AND BACKGROUND: Case series have suggested an association between eosinophilic esophagitis (EoE) and celiac disease (CD) in children. We analyzed a cohort of patients with CD to confirm this association in children, and determine whether it extends into adulthood. METHODS: A database of patients with CD was reviewed to determine the number of patients with comorbid diagnoses of EoE. Histopathology reports of esophageal biopsies were reviewed to identify all cases of increased esophageal eosinophilia. Cases of EoE were diagnosed if biopsies revealed ≥ 15 eosinophils per high power field and associated symptoms were present. Age-adjusted and sex-adjusted standardized incidence ratios (SIR) with corresponding 95% confidence intervals (CI) were calculated in comparison to published US population-derived incidence data. RESULTS: EoE was diagnosed in 4 children and 10 adults. EoE is more common compared with the general population; SIR for children was 35.6 (95% CI, 9.3-79.0) and for adults 13.1 (95% CI, 6.2-22.5). Overall, the age-adjusted and sex-adjusted SIR was 16.0 (95% CI, 8.7-25.5). CONCLUSIONS: The incidence of EoE in our cohort of patients with CD was increased compared with the general population. Coexistent EoE should be considered in patients with CD who have persistent esophageal symptoms.
目的和背景:病例系列研究表明,嗜酸细胞性食管炎(EoE)与儿童乳糜泻(CD)之间存在关联。我们分析了一组 CD 患者的队列,以确认这种关联在儿童中存在,并确定其是否会延伸到成年期。
方法:我们回顾了 CD 患者的数据库,以确定患有 EoE 合并诊断的患者数量。回顾食管活检的组织病理学报告,以确定所有食管嗜酸性粒细胞增多的病例。如果活检显示每高倍视野≥15 个嗜酸性粒细胞且存在相关症状,则诊断为 EoE。与已发表的美国人群衍生发病率数据相比,计算了年龄和性别调整后的标准化发病率比(SIR)及其相应的 95%置信区间(CI)。
结果:在 4 名儿童和 10 名成人中诊断出 EoE。与普通人群相比,EoE 更为常见;儿童的 SIR 为 35.6(95%CI,9.3-79.0),成人的 SIR 为 13.1(95%CI,6.2-22.5)。总体而言,年龄和性别调整后的 SIR 为 16.0(95%CI,8.7-25.5)。
结论:与普通人群相比,我们的 CD 患者队列中 EoE 的发病率增加。患有持续性食管症状的 CD 患者应考虑同时存在 EoE。