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基于多中心联盟 10 年数据,嗜酸细胞性胃炎、胃肠炎和结肠炎的诊断率不断上升,合并率高,治疗模式多样。

Increasing Rates of Diagnosis, Substantial Co-Occurrence, and Variable Treatment Patterns of Eosinophilic Gastritis, Gastroenteritis, and Colitis Based on 10-Year Data Across a Multicenter Consortium.

机构信息

Division of Allergy/Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas, USA.

Center for Esophageal Diseases and Swallowing and Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

出版信息

Am J Gastroenterol. 2019 Jun;114(6):984-994. doi: 10.14309/ajg.0000000000000228.


DOI:10.14309/ajg.0000000000000228
PMID:31008735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6554065/
Abstract

OBJECTIVES: The literature related to eosinophilic gastritis (EG), gastroenteritis (EGE), and colitis (EC) is limited. We aimed to characterize rates of diagnosis, clinical features, and initial treatments for patients with EG, EGE, and EC. METHODS: In this retrospective study, data were collected from 6 centers in the Consortium of Eosinophilic Gastrointestinal Researchers from 2005 to 2016. We analyzed demographics, time trends in diagnosis, medical history, presenting symptoms, disease overlap, and initial treatment patterns/responses. RESULTS: Of 373 subjects (317 children and 56 adults), 38% had EG, 33% EGE, and 29% EC. Rates of diagnosis of all diseases increased over time. There was no male predominance, and the majority of subjects had atopy. Presenting symptoms were similar between diseases with nausea/vomiting and abdominal pain, the most common. One hundred fifty-four subjects (41%) had eosinophilic inflammation outside of their primary disease location with the esophagus the second most common gastrointestinal (GI) segment involved. Multisite inflammation was more common in children than in adults (68% vs 37%; P < 0.001). Initial treatment patterns varied highly between centers. One hundred-nine subjects (29%) had follow-up within 6 months, and the majority had clinical, endoscopic, and histologic improvements. CONCLUSIONS: In this cohort, EG, EGE, and EC were diagnosed more frequently over time, and inflammation of GI segments outside the primary disease site co-occurrence of atopy was common with a lack of male predominance. Symptoms were similar between diseases, and initial treatment strategies were highly variable. Future investigation should assess the cause of the increased prevalence of eosinophilic GI disorders and prospectively assess outcomes to establish treatment algorithms.

摘要

目的:有关嗜酸性胃炎(EG)、胃肠炎(EGE)和结肠炎(EC)的文献有限。我们旨在描述 EG、EGE 和 EC 患者的诊断率、临床特征和初始治疗方法。

方法:在这项回顾性研究中,数据来自 2005 年至 2016 年期间来自嗜酸性胃肠道研究联盟的 6 个中心。我们分析了人口统计学资料、诊断时间趋势、病史、临床表现、疾病重叠以及初始治疗模式/反应。

结果:在 373 名患者(317 名儿童和 56 名成人)中,38%患有 EG,33%患有 EGE,29%患有 EC。所有疾病的诊断率随时间增加。男女比例无差异,大多数患者有特应性。表现症状在不同疾病之间相似,最常见的是恶心/呕吐和腹痛。154 名患者(41%)在主要疾病部位以外的部位存在嗜酸性炎症,食管是第二常见的胃肠道(GI)受累部位。多部位炎症在儿童中比在成人中更常见(68%比 37%;P<0.001)。初始治疗模式在各中心之间差异很大。109 名患者(29%)在 6 个月内进行了随访,大多数患者的临床、内镜和组织学均有改善。

结论:在本队列中,EG、EGE 和 EC 的诊断频率随时间推移而增加,GI 部位以外的炎症与特应性共病常见,且无男性优势。症状在不同疾病之间相似,初始治疗策略差异很大。未来的研究应评估嗜酸性胃肠道疾病患病率增加的原因,并前瞻性评估结局以建立治疗方案。

相似文献

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[3]
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[5]
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[6]
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[7]
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[8]
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[9]
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[1]
Extraintestinal Symptoms of Pain Are Common in Patients With Eosinophilic Gastrointestinal Diseases.

Gastro Hep Adv. 2025-6-19

[2]
Eosinophils Beyond the Esophagus: A Review of Non-EoE Eosinophilic Gastrointestinal Diseases.

Gastroenterol Hepatol (N Y). 2025-8

[3]
Non-eosinophilic esophagitis eosinophilic gastrointestinal diseases are more prevalent than eosinophilic esophagitis in Korean children: from a multicenter study based on new diagnostic criteria and nomenclature.

Front Pediatr. 2025-8-14

[4]
Age-Dependent Clinical Manifestations of Eosinophilic Gastrointestinal Disorders Beyond Eosinophilic Esophagitis.

J Asthma Allergy. 2025-5-15

[5]
Elemental Formulas: Indications of Use in Pediatric Clinical Practice.

Nutrients. 2025-3-12

[6]
Segmental overlap is common in eosinophilic gastrointestinal diseases and impacts clinical presentation and treatment.

Dis Esophagus. 2025-1-7

[7]
A multicenter, retrospective cohort study on the diagnosis, treatment and natural history of eosinophilic gastrointestinal disorders in the Netherlands.

Sci Rep. 2025-3-1

[8]
When Ascites Hides More: A Diagnostic Dilemma in an Unusual Presentation.

Cureus. 2025-1-1

[9]
Biologics for eosinophilic oesophagitis: a systematic review and meta-analysis.

Ann Med. 2025-12

[10]
Eosinophilic duodenitis misdiagnosed as acute pancreatitis in a child: a case report.

BMC Pediatr. 2024-12-18

本文引用的文献

[1]
Eosinophilic oesophagitis endotype classification by molecular, clinical, and histopathological analyses: a cross-sectional study.

Lancet Gastroenterol Hepatol. 2018-5-3

[2]
Individuals affected by eosinophilic gastrointestinal disorders have complex unmet needs and frequently experience unique barriers to care.

Clin Res Hepatol Gastroenterol. 2018-3-31

[3]
Eosinophilic gastroenteritis and other eosinophilic gut diseases distal to the oesophagus.

Lancet Gastroenterol Hepatol. 2018-3-7

[4]
Creating a multi-center rare disease consortium - the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR).

Transl Sci Rare Dis. 2017-12-18

[5]
A Prospective Study on the Prevalence, Extent of Disease and Outcome of Eosinophilic Gastroenteritis in Patients Presenting with Lower Abdominal Symptoms.

Gut Liver. 2018-5-15

[6]
Eosinophilic colitis: Case series and literature review.

Pathol Res Pract. 2017-10-18

[7]
Clinical Implications of Pediatric Colonic Eosinophilia.

J Pediatr Gastroenterol Nutr. 2018-5

[8]
Pathophysiology of Eosinophilic Esophagitis.

Gastroenterology. 2018-1

[9]
Prevalence of Eosinophilic Gastroenteritis and Colitis in a Population-Based Study, From 2012 to 2017.

Clin Gastroenterol Hepatol. 2017-6-8

[10]
Diagnosis of eosinophilic gastroenteritis is easily missed.

World J Gastroenterol. 2017-5-21

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