Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. S.W, Rochester, MN, 55905, USA.
Faculty of Medicine, University of Newcastle, Newcastle, NSW, Australia.
Dig Dis Sci. 2019 Mar;64(3):832-837. doi: 10.1007/s10620-018-5387-7. Epub 2018 Nov 26.
Rumination syndrome is a functional gastrointestinal disorder characterized by effortless, postprandial regurgitation. Duodenal eosinophilia has been described in patients with functional dyspepsia. Because of the significant symptomatic overlap between functional dyspepsia and rumination syndrome, we hypothesized that histological changes might exist among patients with rumination syndrome.
We included patients with rumination syndrome in whom we had obtained duodenal biopsies and compared these with controls. Digital images of biopsy specimens were analyzed for routine pathology and eosinophil counts by a pathologist blinded to the case-control status.
The 22 patients with rumination syndrome had a mean age of 39.2 years (range 21-71) and 77% were female. The 10 controls had a mean age of 34.3 (range 27-69) and 80% were female. There was a significant increase in the mean eosinophil count among the patients with rumination syndrome compared to controls, 26 per mm (range 16-42) versus 18 per mm (range 10-28), p = 0.006. Intraepithelial lymphocyte counts were significantly higher in rumination patients (mean 15/100 enterocytes, range 8-29) versus controls (mean 11/100 enterocytes, range 11-18), p = 0.02.
Patients with rumination syndrome have subtle duodenal pathology with eosinophilia and increased intraepithelial lymphocyte counts compared to controls.
反刍综合征是一种功能性胃肠道疾病，其特征为餐后无需用力即可出现反流。功能性消化不良患者中已描述过十二指肠嗜酸性粒细胞增多症。由于功能性消化不良和反刍综合征之间存在显著的症状重叠，我们假设反刍综合征患者中可能存在组织学变化。
我们纳入了接受过十二指肠活检的反刍综合征患者，并将其与对照组进行了比较。一位对病例对照状态不知情的病理学家对活检标本的数字图像进行了常规病理学和嗜酸性粒细胞计数分析。
22 例反刍综合征患者的平均年龄为 39.2 岁（范围 21-71 岁），77%为女性。10 例对照的平均年龄为 34.3 岁（范围 27-69 岁），80%为女性。与对照组相比，反刍综合征患者的平均嗜酸性粒细胞计数显著增加，分别为 26 个/毫米（范围 16-42）和 18 个/毫米（范围 10-28），p=0.006。反刍综合征患者的上皮内淋巴细胞计数明显高于对照组（平均 15/100 肠上皮细胞，范围 8-29）和对照组（平均 11/100 肠上皮细胞，范围 11-18），p=0.02。
与对照组相比，反刍综合征患者的十二指肠病理学表现为轻微的嗜酸性粒细胞增多和上皮内淋巴细胞计数增加。
