Division of Gastroenterology, Portland VA Medical Center and Oregon Health & Science University, Portland, OR, USA.
Inform Diagnostics, Irving, TX, USA.
Dis Esophagus. 2020 Oct 12;33(10). doi: 10.1093/dote/doaa064.
Eosinophilic esophagitis, gastritis, duodenitis, and colitis are rare diseases. Few studies have been able to accumulate sufficiently large number of patients to analyze their clinical epidemiology. The aim of the present epidemiologic study was to examine the prevalence and concordant occurrence of gastrointestinal (GI) eosinophilia. Using a database of histopathologic records, a cross-sectional study among 302,061 patients undergoing bidirectional endoscopy evaluated the concordant occurrence of esophageal, gastric, duodenal, and colonic eosinophilia. The prevalence rates (PRs) of GI eosinophilia were expressed per 1,000 study subjects with their 95% Poisson confidence intervals (CIs). The concordant occurrence of various forms of GI eosinophilia was compared to their overall occurrence in the study population by calculating odds ratios (ORs) and their 95% CI. The database contained 3,008 patients with esophageal eosinophilia (PR = 9.96, 9.61-10.32), 366 patients with gastric eosinophilia (1.21, 1.09-1.34), 10 patients with duodenal eosinophilia (0.03, 0.02-0.06), and 124 patients with colonic eosinophilia (0.41, 0.34-0.49). The occurrence of esophageal eosinophilia was associated with an increased occurrence of gastric eosinophilia (OR = 3.58, 2.06-6.23), duodenal (40.22, 12.61-128.31), and colonic eosinophilia (8.12, 4.26-15.49). Similarly, we also found statistically significant associations between gastric eosinophilia and duodenal or colonic eosinophilia, and between duodenal and colonic eosinophilia. In the adult, as in the pediatric population, patients with any type of GI eosinophilia are at an increased risk for simultaneously harboring eosinophilia at multiple sites of their GI tract. With the exception of esophageal eosinophilia, however, other forms of GI eosinophilia are rarely diagnosed.
嗜酸粒细胞性食管炎、胃炎、十二指肠炎和结肠炎均较为罕见。目前，仅有少数研究能够积累足够数量的患者以分析其临床流行病学。本研究旨在调查胃肠道（GI）嗜酸粒细胞增多症的流行率和一致发生情况。我们使用组织病理学记录数据库，对 302061 例接受双向内镜检查的患者进行了横断面研究，评估了食管、胃、十二指肠和结肠嗜酸粒细胞增多症的一致发生情况。GI 嗜酸粒细胞增多症的流行率（PR）以每千名研究对象表示，并附有 95%的泊松置信区间（CI）。通过计算比值比（OR）及其 95%CI，将各种形式的 GI 嗜酸粒细胞增多症的一致发生情况与研究人群中的总体发生情况进行比较。该数据库包含 3008 例食管嗜酸粒细胞增多症患者（PR=9.96，9.61-10.32）、366 例胃嗜酸粒细胞增多症患者（1.21，1.09-1.34）、10 例十二指肠嗜酸粒细胞增多症患者（0.03，0.02-0.06）和 124 例结肠嗜酸粒细胞增多症患者（0.41，0.34-0.49）。食管嗜酸粒细胞增多症的发生与胃嗜酸粒细胞增多症（OR=3.58，2.06-6.23）、十二指肠（40.22，12.61-128.31）和结肠嗜酸粒细胞增多症（8.12，4.26-15.49）的发生率增加相关。同样，我们还发现胃嗜酸粒细胞增多症与十二指肠或结肠嗜酸粒细胞增多症之间，以及十二指肠与结肠嗜酸粒细胞增多症之间存在统计学显著相关性。与儿科人群一样，在成人中，任何类型的 GI 嗜酸粒细胞增多症患者同时存在胃肠道多个部位嗜酸粒细胞增多症的风险增加。然而，除了食管嗜酸粒细胞增多症外，其他形式的 GI 嗜酸粒细胞增多症很少被诊断。
