Thirumal P, Keerthivasan Seetharaman, Senthamizhselvan Kuppusamy
Royal Care Super speciality Hospital, Coimbatore, Tamil Nadu, India.
Department of Pediatric Gastroenterology, Hepatology and Liver transplantation, Rainbow Children Hospital, Chennai, India.
Curr Gastroenterol Rep. 2025 Aug 11;27(1):60. doi: 10.1007/s11894-025-01009-y.
Eosinophilic colitis (EoC) has an increasing association with inflammatory bowel disease (IBD), and there is a paucity of data on the natural history of EoC. Here, we provide a comprehensive overview of EoC and critically evaluate the evidence supporting its potential association with, or evolution into IBD.
Experts currently classify EoC as one of the eosinophilic gastrointestinal disorders (EGID) beyond eosinophilic esophagitis (EoE). Transcriptomic analyses have demonstrated a distinct molecular signature for EoC. However, recent studies suggest that a subset of patients with EoC may progress to develop IBD. The key predictive factors include high eosinophilic density on colonic biopsy and poor response or relapse following standard therapy. Emerging evidence suggests that EoC may precede or overlap with IBD. The lack of standardized diagnostic criteria and limited longitudinal data hinder firm conclusions and warrant future prospective multicenter studies. Available current literature suggests that clinicians should be vigilant with persistent or severe symptomatic patients despite standard treatment to evaluate for IBD.
嗜酸性结肠炎（EoC）与炎症性肠病（IBD）的关联日益增加，而关于EoC自然史的数据却很匮乏。在此，我们对EoC进行全面概述，并严格评估支持其与IBD潜在关联或演变为IBD的证据。
专家目前将EoC归类为除嗜酸性食管炎（EoE）之外的嗜酸性胃肠道疾病（EGID）之一。转录组分析已证明EoC具有独特的分子特征。然而，最近的研究表明，一部分EoC患者可能会进展为IBD。关键预测因素包括结肠活检时嗜酸性粒细胞密度高以及标准治疗后反应不佳或复发。新出现的证据表明，EoC可能先于IBD出现或与之重叠。缺乏标准化诊断标准和有限的纵向数据阻碍了得出确凿结论，因此需要未来进行前瞻性多中心研究。现有文献表明，尽管进行了标准治疗，但对于持续或严重症状的患者，临床医生仍应保持警惕，以评估是否患有IBD。
