Ketchem Corey J, Jensen Elizabeth T, Dai Xiangfeng, Anderson Chelsea, Kodroff Ellyn, Strobel Mary Jo, Zicarelli Amy, Gray Sarah, Cordell Amanda, Hiremath Girish, Dellon Evan S
Department of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Dis Esophagus. 2025 Jan 7;38(1). doi: 10.1093/dote/doaf011.
Little is known about the extent or importance of overlapping gastrointestinal (GI) tract involvement in eosinophilic gastrointestinal diseases (EGIDs), how presentations differ by areas of involvement, and whether overlap impacts treatments. We aimed to evaluate overlapping GI tract involvement in EGIDs and whether clinical differences existed. To do this, we assessed the EGID Partners cohort, an online patient-centered research network. Adults (≥18 years) and caregivers of children <18 years old with EoE or non-EoE EGIDs could join. Surveys were completed at enrollment, comparing patients with EoE alone, EGID without esophageal involvement ('EGID-NE'), and EGID with esophageal involvement ('EGID-WE'). Of 527 cases enrolled, 402 had EoE alone and 125 had non-EoE EGID, 57 (46%) with EGID-NE, and 68 (53%) with EGID-WE. There were 10, 18, and 9 with eosinophilic gastritis, gastroenteritis, and colitis alone, respectively; 88 had overlap. EGID-NE had a higher proportion of females (79%; P < 0.001), and family history of EoE/EGID was more common in EGID-WE (19% vs. 11% in EoE and 7% in EGID-NE; P = 0.007). Patient-Reported Outcomes Measurement Information System measures for anxiety were above general population averages and highest for EGID-WE. Treatments such as elemental formula (47% vs. 32% vs. 20%; P = 0.001), systemic steroids (33% vs. 56% vs. 14%; P < 0.001), and biologics were also more common in EGID-WE and EGID-NE. In conclusion, overlap in regions with eosinophilic infiltration is common for non-EoE EGIDs, with more than half of non-EoE EGIDs having esophageal involvement and a high proportion of multisegmental involvement. EGID-WE patients tended to have more disease burden.
对于嗜酸性粒细胞性胃肠道疾病（EGIDs）中胃肠道（GI）重叠受累的程度或重要性、不同受累部位的表现差异以及重叠是否影响治疗，我们知之甚少。我们旨在评估EGIDs中胃肠道的重叠受累情况以及是否存在临床差异。为此，我们评估了EGID Partners队列，这是一个以患者为中心的在线研究网络。患有嗜酸性食管炎（EoE）或非EoE的EGIDs的成年人（≥18岁）以及18岁以下儿童的护理人员均可加入。在入组时完成调查，比较单纯患有EoE的患者、无食管受累的EGID（“EGID-NE”）和有食管受累的EGID（“EGID-WE”）。在527例入组病例中，402例单纯患有EoE，125例患有非EoE的EGID，其中57例（46%）为EGID-NE，68例（53%）为EGID-WE。分别有10例、18例和9例单独患有嗜酸性胃炎、嗜酸性胃肠炎和嗜酸性结肠炎；88例存在重叠。EGID-NE女性比例更高（79%；P < 0.001），EoE/EGID家族史在EGID-WE中更常见（EoE中为19%，EGID-NE中为11%，EGID-WE中为7%；P = 0.007）。患者报告的焦虑症结局测量信息系统指标高于一般人群平均水平，在EGID-WE中最高。要素配方奶粉（47%对32%对20%；P = 0.001）、全身用类固醇（33%对56%对14%；P < 0.001）和生物制剂等治疗方法在EGID-WE和EGID-NE中也更常见。总之，嗜酸性粒细胞浸润区域的重叠在非EoE的EGIDs中很常见，超过一半的非EoE的EGIDs有食管受累且多节段受累比例很高。EGID-WE患者往往疾病负担更重。
