Duodenal Pathology in Patients with Rumination Syndrome: Duodenal Eosinophilia and Increased Intraepithelial Lymphocytes.
Duodenal eosinophilia
Functional dyspepsia
Rumination syndrome
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
20
10
2018
accepted:
17
11
2018
pubmed:
28
11
2018
medline:
6
8
2019
entrez:
28
11
2018
Statut:
ppublish
Résumé
Rumination syndrome is a functional gastrointestinal disorder characterized by effortless, postprandial regurgitation. Duodenal eosinophilia has been described in patients with functional dyspepsia. Because of the significant symptomatic overlap between functional dyspepsia and rumination syndrome, we hypothesized that histological changes might exist among patients with rumination syndrome. We included patients with rumination syndrome in whom we had obtained duodenal biopsies and compared these with controls. Digital images of biopsy specimens were analyzed for routine pathology and eosinophil counts by a pathologist blinded to the case-control status. The 22 patients with rumination syndrome had a mean age of 39.2 years (range 21-71) and 77% were female. The 10 controls had a mean age of 34.3 (range 27-69) and 80% were female. There was a significant increase in the mean eosinophil count among the patients with rumination syndrome compared to controls, 26 per mm Patients with rumination syndrome have subtle duodenal pathology with eosinophilia and increased intraepithelial lymphocyte counts compared to controls.
Sections du résumé
BACKGROUND
Rumination syndrome is a functional gastrointestinal disorder characterized by effortless, postprandial regurgitation. Duodenal eosinophilia has been described in patients with functional dyspepsia. Because of the significant symptomatic overlap between functional dyspepsia and rumination syndrome, we hypothesized that histological changes might exist among patients with rumination syndrome.
METHODS
We included patients with rumination syndrome in whom we had obtained duodenal biopsies and compared these with controls. Digital images of biopsy specimens were analyzed for routine pathology and eosinophil counts by a pathologist blinded to the case-control status.
RESULTS
The 22 patients with rumination syndrome had a mean age of 39.2 years (range 21-71) and 77% were female. The 10 controls had a mean age of 34.3 (range 27-69) and 80% were female. There was a significant increase in the mean eosinophil count among the patients with rumination syndrome compared to controls, 26 per mm
CONCLUSION
Patients with rumination syndrome have subtle duodenal pathology with eosinophilia and increased intraepithelial lymphocyte counts compared to controls.
Identifiants
pubmed: 30478768
doi: 10.1007/s10620-018-5387-7
pii: 10.1007/s10620-018-5387-7
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
832-837Références
Gastroenterology. 2006 Apr;130(5):1466-79
pubmed: 16678560
Am J Gastroenterol. 2015 Aug;110(8):1205-15
pubmed: 26077177
Gastroenterology. 2010 Jul;139(1):112-9
pubmed: 20398668
Neurogastroenterol Motil. 2016 Mar;28(3):384-91
pubmed: 26661735
J Neurogastroenterol Motil. 2013 Apr;19(2):259-60
pubmed: 23667759
Cell Mol Immunol. 2013 Sep;10(5):383-92
pubmed: 23934026
Clin Gastroenterol Hepatol. 2003 Jul;1(4):264-72
pubmed: 15017667
Dig Dis Sci. 2018 Dec;63(12):3178-3186
pubmed: 30276571
Am J Gastroenterol. 2002 Sep;97(9):2290-9
pubmed: 12358247
BMC Gastroenterol. 2012 Nov 16;12:163
pubmed: 23157670
Am J Gastroenterol. 2014 Jan;109(1):52-9
pubmed: 24366235
Gastroenterology. 2016 May;150(6):1380-92
pubmed: 27147122
J Gastroenterol Hepatol. 2014 Mar;29(3):474-9
pubmed: 24304041
Aliment Pharmacol Ther. 2013 Jan;37(2):263-74
pubmed: 23173868
Clin Gastroenterol Hepatol. 2015 Jan;13(1):100-6.e1
pubmed: 24768808
Gastroenterology. 1996 Mar;110(3):740-7
pubmed: 8608883
J Clin Diagn Res. 2017 Jun;11(6):EC01-EC04
pubmed: 28764169
Gut. 2014 Feb;63(2):262-71
pubmed: 23474421
Gastroenterol Res Pract. 2012;2012:606174
pubmed: 22474443
Am J Physiol. 1998 Aug;275(2):G314-21
pubmed: 9688659
Sci Rep. 2016 Oct 06;6:34305
pubmed: 27708358
Aliment Pharmacol Ther. 2009 Apr 1;29(7):765-73
pubmed: 19183150
Am J Gastroenterol. 2016 Jul;111(7):1007-13
pubmed: 27185077
Clin Gastroenterol Hepatol. 2007 Oct;5(10):1175-83
pubmed: 17686660
Aliment Pharmacol Ther. 2017 May;45(10):1358-1364
pubmed: 28326599
J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):930-932
pubmed: 27579694
Gut. 2014 Aug;63(8):1210-28
pubmed: 24917550
Histopathology. 2011 Aug;59(2):166-79
pubmed: 21054494
N Engl J Med. 2015 Nov 5;373(19):1853-63
pubmed: 26535514
Ann Intern Med. 1986 Oct;105(4):513-8
pubmed: 3752757