Division of Eosinophilic Gastrointestinal Disorders, National Research Institute for Child Health and Development, Tokyo, Japan.
Division of Allergy and Immunology, Gunma Children's Medical Center, Gunma, Japan.
J Allergy Clin Immunol Pract. 2021 Sep;9(9):3339-3349.e8. doi: 10.1016/j.jaip.2021.06.026. Epub 2021 Jun 29.
BACKGROUND: Eosinophilic esophagitis (EoE) has increased rapidly and has been well characterized. However, no nationwide survey has been conducted regarding non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs), and they remain poorly understood. OBJECTIVE: To compare the clinical features and natural histories of non-EoE EGIDs and EoE by using the same questionnaire, for all ages. METHODS: We conducted a nationwide hospital-based survey of patients who visited hospitals from January 2013 through December 2017. We randomly selected 10,000 hospitals that perform endoscopy. We analyzed the demographics, symptoms, gastrointestinal histology, treatments, and natural histories of EoE and non-EoE EGIDs. RESULTS: A total of 2906 hospitals responded to the questionnaire. We identified 1542 patients and obtained detailed data for 786 patients, consisting of 39% EoE and 61% non-EoE EGIDs. The clinical characteristics were analyzed for patients who met the "definite" criteria that excluded comorbidities. Non-EoE EGIDs showed no gender difference, whereas EoE was male-predominant. Tissue eosinophilia was often seen in the small intestine (62%) and stomach (49%). The frequency of hypoproteinemia was high (27%) in childhood. Children also had more serious symptoms and complications than adults: restriction of daily life activity (P = .009), failure to grow/weight loss (P = .008), and surgery (P = .01). For both diseases, the most common natural history was the continuous type: 66% (95% confidence interval [CI]: 58-74) in EoE and 64% (95% CI: 55-72) in non-EoE EGIDs. CONCLUSIONS: The percentage of persistent patients with non-EoE EGIDs was almost the same as those with EoE. Complications were more frequent in children than in adults.
背景:嗜酸性食管炎(EoE)的发病率迅速上升,并已得到充分认识。然而,目前尚未开展全国性调查来了解非嗜酸性食管炎胃肠道疾病(非 EoE EGIDs),且人们对其了解甚少。 目的:通过使用相同的问卷,比较非 EoE EGIDs 和 EoE 的临床特征和自然病史,适用于所有年龄段。 方法:我们对 2013 年 1 月至 2017 年 12 月期间就诊于医院的患者进行了一项全国性基于医院的调查。我们随机选择了 10,000 家开展内镜检查的医院。我们分析了 EoE 和非 EoE EGIDs 的人口统计学、症状、胃肠道组织学、治疗方法和自然病史。 结果:共 2906 家医院回复了问卷。我们确定了 1542 名患者,并获得了 786 名患者的详细数据,其中包括 39%的 EoE 和 61%的非 EoE EGIDs。我们对符合排除合并症的“明确”标准的患者进行了临床特征分析。非 EoE EGIDs 无性别差异,而 EoE 则以男性为主。小肠(62%)和胃(49%)组织中经常出现嗜酸性粒细胞浸润。儿童低蛋白血症的发生率较高(27%)。儿童的症状和并发症也比成人更严重:日常生活活动受限(P =.009)、生长/体重减轻失败(P =.008)和手术(P =.01)。对于这两种疾病,最常见的自然病史是持续型:EoE 中为 66%(95%可信区间 [CI]:58-74),非 EoE EGIDs 中为 64%(95% CI:55-72)。 结论:非 EoE EGIDs 持续存在的患者比例几乎与 EoE 相同。儿童的并发症比成人更常见。
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