Lee Kunsong, Kang Ben, Kim Eun Sil, Yi Dae Yong, Kim Tae Hyeong, Lee Yoo Min, Choi Sujin, Choe Byung-Ho
Department of Pediatrics, Dankook University College of Medicine, Cheonan, Republic of Korea.
Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Front Pediatr. 2025 Aug 14;13:1656107. doi: 10.3389/fped.2025.1656107. eCollection 2025.
Eosinophilic gastrointestinal diseases (EGIDs) are chronic inflammatory disorders characterized by eosinophilic infiltration of the gastrointestinal (GI) tract. This study aimed to investigate the epidemiological and clinical characteristics of pediatric EGIDs in Korea based on the newly established nomenclature and diagnostic guidelines.
A retrospective analysis was conducted on pediatric patients (0-18 years) with GI symptoms who underwent upper and lower GI endoscopy at five tertiary hospitals in Korea (2010∼2023). Patients were classified based on the latest diagnostic criteria into eosinophilic esophagitis (EoE) and non-eosinophilic esophagitis eosinophilic gastrointestinal disease (non-EoE EGIDs), including eosinophilic gastritis (EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC). Clinical, laboratory, and endoscopic findings were analyzed.
Among a total of 4,972 pediatric endoscopic procedures (3,300 upper and 1,672 lower), 63 cases (1.3%) of EGIDs were diagnosed, with non-EoE EGIDs (65.1%) being more prevalent than EoE (34.9%). Within the non-EoE EGIDs group, EoG was the most common subtype (33.3%), followed by EoN (20.6%) and EoC (7.9%). Multi-site involvement was observed in 30.2% with frequent esophageal involvement (EI). Endoscopic abnormalities, including rings and furrows in EoE and ulcers in non-EoE EGIDs, were common. Peripheral eosinophil counts and fecal calprotectin levels were significantly higher in non-EoE EGIDs with EI than in EoE ( < 0.05). The relapse rates exceeded 20% across all subtypes.
This study highlights the distinctive epidemiology of pediatric EGIDs in Korea, where non-EoE EGIDs are more prevalent than EoE, contrasting with Western reports. Peripheral eosinophil counts and fecal calprotectin levels were significantly higher in non-EoE EGIDs with EI than in EoE.
嗜酸性粒细胞性胃肠疾病（EGIDs）是一类以胃肠道嗜酸性粒细胞浸润为特征的慢性炎症性疾病。本研究旨在基于新制定的命名法和诊断指南，调查韩国儿童EGIDs的流行病学和临床特征。
对韩国五家三级医院（2010年至2023年）接受上、下消化道内镜检查的有胃肠道症状的儿科患者（0至18岁）进行回顾性分析。根据最新诊断标准，将患者分为嗜酸性粒细胞性食管炎（EoE）和非嗜酸性粒细胞性食管炎嗜酸性粒细胞性胃肠疾病（非EoE EGIDs），后者包括嗜酸性粒细胞性胃炎（EoG）、嗜酸性粒细胞性肠炎（EoN）和嗜酸性粒细胞性结肠炎（EoC）。对临床、实验室和内镜检查结果进行分析。
在总共4972例儿科内镜检查中（3300例上消化道检查和1672例下消化道检查），诊断出63例（1.3%）EGIDs，非EoE EGIDs（65.1%）比EoE（34.9%）更常见。在非EoE EGIDs组中，EoG是最常见的亚型（33.3%），其次是EoN（20.6%）和EoC（7.9%）。30.2%的患者存在多部位受累，食管受累频繁（EI）。内镜异常很常见，包括EoE中的环和沟以及非EoE EGIDs中的溃疡。伴有EI的非EoE EGIDs患者外周血嗜酸性粒细胞计数和粪便钙卫蛋白水平显著高于EoE患者（P<0.05）。所有亚型的复发率均超过20%。
本研究突出了韩国儿童EGIDs独特的流行病学特征，即非EoE EGIDs比EoE更常见，这与西方报道形成对比。伴有EI的非EoE EGIDs患者外周血嗜酸性粒细胞计数和粪便钙卫蛋白水平显著高于EoE患者。
