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