Zhan Chun-Lei, You Jie-Yu, Li Xiao-Qin, Wang Yong, Mei Xian-Qin, Wan Sheng-Hua
Department of Gastroenterology, Jiangxi Children's Hospital, Nanchang 330000, China (Wan S-H, Email: jeft1210@ 126. com).
Zhongguo Dang Dai Er Ke Za Zhi. 2024 Feb 15;26(2):139-144. doi: 10.7499/j.issn.1008-8830.2306040.
To explore the clinical manifestations, endoscopic findings, histopathological changes, treatment, and prognosis of eosinophilic gastrointestinal disease (EGID) in children, with the aim of enhancing awareness among pediatricians about this condition.
Data of 267 children with EGID were prospectively collected from January 2019 to July 2022 at Jiangxi Children's Hospital, Hunan Children's Hospital, and Henan Children's Hospital. The age of onset, symptoms, physical signs, laboratory examination results, endoscopic findings, histopathological changes, and treatment outcomes were observed.
Among the 267 children with EGID, the majority had mild (164 cases, 61.4%) or moderate (96 cases, 35.6%) clinical severity. The disease occurred at any age, with a higher prevalence observed in school-age children (178 cases). The main symptoms in infants were vomiting and hematemesis, while in toddlers, vomiting and bloody stools were prominent. Abdominal pain and vomiting were the primary symptoms in preschool and school-age children. Nearly half (49.4%) of the affected children showed elevated platelet counts on hematological examination, but there was no significant difference in platelet counts among children with mild, moderate, and severe EGID (>0.05). Endoscopic findings in EGID children did not reveal significant specificity, and histopathological examination showed no specific structural damage. Among them, 85.0% (227 cases) received acid suppression therapy, 34.5% (92 cases) practiced dietary avoidance, 20.9% (56 cases) received anti-allergic medication, and a small proportion (24 cases, 9.0%) were treated with prednisone. Clinical symptoms were relieved in all patients after treatment, but three cases with peptic ulcers experienced recurrence after drug discontinuation.
Mild and moderate EGID are more common in children, with no specific endoscopic findings. Dietary avoidance, acid suppression therapy, and anti-allergic medication are the main treatment methods. The prognosis of EGID is generally favorable in children.
探讨儿童嗜酸性粒细胞性胃肠病（EGID）的临床表现、内镜检查结果、组织病理学变化、治疗及预后，以提高儿科医生对该病的认识。
前瞻性收集2019年1月至2022年7月在江西省儿童医院、湖南省儿童医院和河南省儿童医院就诊的267例EGID患儿的数据。观察发病年龄、症状、体征、实验室检查结果、内镜检查结果、组织病理学变化及治疗效果。
267例EGID患儿中，多数病情为轻度（164例，61.4%）或中度（96例，35.6%）。该病可发生于任何年龄，学龄期儿童患病率较高（178例）。婴儿期主要症状为呕吐和呕血，幼儿期呕吐和便血较为突出。学龄前和学龄期儿童的主要症状为腹痛和呕吐。近半数（49.4%）患儿血液学检查显示血小板计数升高，但轻度、中度和重度EGID患儿的血小板计数差异无统计学意义（>0.05）。EGID患儿的内镜检查结果无明显特异性，组织病理学检查也未显示特定的结构损伤。其中，85.0%（227例）接受了抑酸治疗，34.5%（92例）进行了饮食回避，20.9%（56例）接受了抗过敏药物治疗，小部分（24例，9.0%）接受了泼尼松治疗。所有患儿治疗后临床症状均缓解，但3例消化性溃疡患儿停药后复发。
儿童EGID以轻度和中度多见，内镜检查无特异性表现。饮食回避、抑酸治疗和抗过敏药物治疗是主要治疗方法。儿童EGID的预后一般良好。
