Henriksen Stine D, Hansen Stine K, Heinesen Mia, Terkelsen Jacob H, Hollænder Martin, Bredal Kasper, Melgaard Dorte, Krarup Anne L
Department of Gastrointestinal Surgery Aalborg University Hospital Aalborg Denmark.
Department of Clinical Medicine Aalborg University Aalborg Denmark.
JGH Open. 2023 Aug 17;7(8):553-558. doi: 10.1002/jgh3.12947. eCollection 2023 Aug.
BACKGROUND AND AIM: The DanEoE is a previously described population- and register-based cohort of 236 adult patients with eosinophilic esophagitis (EoE) in a well-defined Danish region with a population of 580 000 and free medical treatment. The aim of the study was to compare the phenotype and treatment response between EoE patients with complications to patients without complications at diagnosis. METHODS: A retrospective cross-sectional study of the DanEoE cohort's 236 adult EoE patients diagnosed between 2007 and 2017 in the North Denmark Region. Patients were divided into a group who had had complications (dilated or food bolus obstruction [FBO]) before or at the diagnosis, and a group without. RESULTS: At the diagnostic endoscopy, 61% had never had a complication, and 39% had either had FBO ( = 77) or been dilated ( = 15). The complicated group had the same mean age at symptom debut (37 [SD = 16] 37 [SD = 17] years, = 1.0), but were diagnosed significantly later with a resulting longer diagnostic delay (13 [SD = 13] 7.9 [SD = 11] years, = 0.01). Almost half of all patients were never treated to symptomatic remission (uncomplicated 40%, complicated 49%). The histological remission was not secured in the majority (uncomplicated 68%, complicated 70%). Despite this, <15% of patients with previous FBO experienced this after the diagnosis. CONCLUSION: In the population-based DanEoE cohort, results indicated that the complicated EoE phenotype was a patient with a 5-year longer diagnostic delay. In the current study, the complication status did not predict the treatment response.
背景与目的:丹麦嗜酸性食管炎(DanEoE)是此前所描述的一个基于人群和登记系统的队列,由丹麦一个明确划定的地区的236例成年嗜酸性食管炎(EoE)患者组成,该地区人口为58万,且提供免费医疗。本研究的目的是比较诊断时伴有并发症的EoE患者与无并发症患者的表型和治疗反应。 方法:对2007年至2017年在丹麦北部地区诊断的DanEoE队列中的236例成年EoE患者进行回顾性横断面研究。患者被分为在诊断前或诊断时出现并发症(扩张或食物团块梗阻[FBO])的组和无并发症的组。 结果:在诊断性内镜检查时,61%的患者从未出现过并发症,39%的患者曾出现FBO(n = 77)或接受过扩张治疗(n = 15)。并发症组在症状首次出现时的平均年龄相同(37[标准差=16]对37[标准差=17]岁,P = 1.0),但诊断明显更晚,导致诊断延迟更长(13[标准差=13]对7.9[标准差=11]年,P = 0.01)。几乎一半的患者从未接受治疗至症状缓解(无并发症组为40%,并发症组为49%)。大多数患者未实现组织学缓解(无并发症组为68%,并发症组为70%)。尽管如此,既往有FBO的患者中<15%在诊断后仍经历过FBO。 结论:在基于人群的DanEoE队列中,结果表明,伴有并发症的EoE表型患者诊断延迟长5年。在本研究中,并发症状态不能预测治疗反应。
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