Jensen Elizabeth T, Martin Christopher F, Kappelman Michael D, Dellon Evan S
*Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine †Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine ‡Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill.
J Pediatr Gastroenterol Nutr. 2016 Jan;62(1):36-42. doi: 10.1097/MPG.0000000000000865.
Eosinophilic esophagitis (EoE) is becoming increasingly more common, but the prevalence of other eosinophilic gastrointestinal disorders (EGIDs) is unknown. Our objective was to estimate the prevalence of eosinophilic gastritis, gastroenteritis, and colitis in the United States.
We used the IMS Health LifeLink PharMetrics Plus Claims Database, data representative of a US national commercially insured population containing medical and pharmaceutical claims for > 75 million individuals. We restricted our sample to patients ages 0 to 64 with continuous enrollment between July 1, 2009, and June 30, 2011. We identified patients with eosinophilic gastritis, gastroenteritis, and colitis as defined by ≥ 1 instance of the International Classification of Diseases, Ninth Revision codes 535.70, 558.41, and 558.42, respectively. We calculated the prevalence of the codes in the database and then standardized the estimates to the US population by age and sex.
The standardized estimated prevalences of eosinophilic gastritis, gastroenteritis, and colitis were 6.3/100,000, 8.4/100,000, and 3.3/100,000, respectively. The prevalence of eosinophilic gastroenteritis was the highest among children age < 5 years, whereas eosinophilic gastritis was more prevalent among older age groups. We observed no age differences for eosinophilic colitis. Among affected patients, there was a high proportion of coexisting allergic conditions, 38.5% for eosinophilic gastritis, 45.6% for gastroenteritis, and 41.8% for colitis. Concomitant allergic disease was most commonly identified in pediatric patients.
The prevalence of non-EoE EGIDs remains rare in the United States, with < 50,000 total patients affected. There appears to be a female predominance and a high co-occurrence of atopic comorbidities.
嗜酸性粒细胞性食管炎(EoE)正变得越来越常见,但其他嗜酸性粒细胞性胃肠道疾病(EGID)的患病率尚不清楚。我们的目的是估计美国嗜酸性粒细胞性胃炎、胃肠炎和结肠炎的患病率。
我们使用了艾美仕市场研究公司(IMS Health)的LifeLink PharMetrics Plus索赔数据库,该数据代表了美国全国商业保险人群,包含超过7500万个人的医疗和药品索赔信息。我们将样本限制为2009年7月1日至2011年6月30日期间持续参保的0至64岁患者。我们根据国际疾病分类第九版(ICD-9)编码535.70、558.41和558.42分别出现≥1次来确定嗜酸性粒细胞性胃炎、胃肠炎和结肠炎患者。我们计算了数据库中这些编码的患病率,然后按年龄和性别将估计值标准化到美国人群。
嗜酸性粒细胞性胃炎、胃肠炎和结肠炎的标准化估计患病率分别为6.3/10万、8.4/10万和3.3/10万。嗜酸性粒细胞性胃肠炎在<5岁儿童中患病率最高,而嗜酸性粒细胞性胃炎在老年人群中更为普遍。我们未观察到嗜酸性粒细胞性结肠炎存在年龄差异。在受影响的患者中,共存过敏状况的比例很高,嗜酸性粒细胞性胃炎为38.5%,胃肠炎为45.6%,结肠炎为41.8%。合并的过敏性疾病在儿科患者中最常见。
在美国,非EoE的EGID患病率仍然很低,受影响的患者总数<50000。似乎女性占主导,且特应性合并症的共病率很高。