Increasing Rates of Diagnosis, Substantial Co-Occurrence, and Variable Treatment Patterns of Eosinophilic Gastritis, Gastroenteritis, and Colitis Based on 10-Year Data Across a Multicenter Consortium.


Journal

The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030

Informations de publication

Date de publication:
06 2019
Historique:
pubmed: 23 4 2019
medline: 28 2 2020
entrez: 23 4 2019
Statut: ppublish

Résumé

The literature related to eosinophilic gastritis (EG), gastroenteritis (EGE), and colitis (EC) is limited. We aimed to characterize rates of diagnosis, clinical features, and initial treatments for patients with EG, EGE, and EC. In this retrospective study, data were collected from 6 centers in the Consortium of Eosinophilic Gastrointestinal Researchers from 2005 to 2016. We analyzed demographics, time trends in diagnosis, medical history, presenting symptoms, disease overlap, and initial treatment patterns/responses. Of 373 subjects (317 children and 56 adults), 38% had EG, 33% EGE, and 29% EC. Rates of diagnosis of all diseases increased over time. There was no male predominance, and the majority of subjects had atopy. Presenting symptoms were similar between diseases with nausea/vomiting and abdominal pain, the most common. One hundred fifty-four subjects (41%) had eosinophilic inflammation outside of their primary disease location with the esophagus the second most common gastrointestinal (GI) segment involved. Multisite inflammation was more common in children than in adults (68% vs 37%; P < 0.001). Initial treatment patterns varied highly between centers. One hundred-nine subjects (29%) had follow-up within 6 months, and the majority had clinical, endoscopic, and histologic improvements. In this cohort, EG, EGE, and EC were diagnosed more frequently over time, and inflammation of GI segments outside the primary disease site co-occurrence of atopy was common with a lack of male predominance. Symptoms were similar between diseases, and initial treatment strategies were highly variable. Future investigation should assess the cause of the increased prevalence of eosinophilic GI disorders and prospectively assess outcomes to establish treatment algorithms.

Identifiants

pubmed: 31008735
doi: 10.14309/ajg.0000000000000228
pmc: PMC6554065
mid: NIHMS1523540
doi:

Substances chimiques

Anti-Inflammatory Agents 0
Gastrointestinal Agents 0

Types de publication

Journal Article Multicenter Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

984-994

Subventions

Organisme : NIDDK NIH HHS
ID : K23 DK109263
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK078392
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK007634
Pays : United States
Organisme : NIAID NIH HHS
ID : U54 AI117804
Pays : United States

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Auteurs

Robert D Pesek (RD)

Division of Allergy/Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas, USA.

Craig C Reed (CC)

Center for Esophageal Diseases and Swallowing and Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

Amanda B Muir (AB)

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Patricia C Fulkerson (PC)

Division of Allergy/Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Calies Menard-Katcher (C)

Division of Gastroenterology, Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado, USA.

Gary W Falk (GW)

Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Jonathan Kuhl (J)

Division of Allergy/Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Ellen K Martin (EK)

Division of Allergy/Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas, USA.

Adam Z Magier (AZ)

Division of Allergy/Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Faria Ahmed (F)

Division of Gastroenterology, Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado, USA.

Maureen Demarshall (M)

Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Ankur Gupta (A)

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Jonathan Gross (J)

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Tokunbo Ashorobi (T)

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Christina L Carpenter (CL)

Rare Disease Clinical Research Network Data Coordinating Center, Health Informatics Institute, University of South Florida, Tampa, Florida, USA.

Jeffrey P Krischer (JP)

Rare Disease Clinical Research Network Data Coordinating Center, Health Informatics Institute, University of South Florida, Tampa, Florida, USA.

Nirmala Gonsalves (N)

Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Jonathan M Spergel (JM)

Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Sandeep K Gupta (SK)

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Illinois and the University of Illinois College of Medicine, Peoria, Illinois, USA.

Glenn T Furuta (GT)

Division of Gastroenterology, Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado, USA.

Marc E Rothenberg (ME)

Division of Allergy/Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Evan S Dellon (ES)

Center for Esophageal Diseases and Swallowing and Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

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