Disease Course and Treatment Response of Eosinophilic Gastrointestinal Diseases in Children With Liver Transplantation: Long-Term Follow-Up.
Age Factors
Anti-Allergic Agents
/ therapeutic use
Biliary Atresia
/ surgery
Budesonide
/ therapeutic use
Child
Child, Preschool
Cholestasis, Intrahepatic
/ surgery
Dermatitis, Atopic
/ epidemiology
Disease Progression
Drug Tapering
Enteritis
/ drug therapy
Enterocolitis
/ drug therapy
Eosinophilia
/ drug therapy
Eosinophilic Esophagitis
/ drug therapy
Epstein-Barr Virus Infections
/ epidemiology
Female
Follow-Up Studies
Gastritis
/ drug therapy
Glucocorticoids
/ therapeutic use
Graft Rejection
/ prevention & control
Humans
Hypersensitivity
/ epidemiology
Immunosuppressive Agents
/ therapeutic use
Infant
Ketotifen
/ therapeutic use
Liver Failure, Acute
/ surgery
Liver Transplantation
Lymphoproliferative Disorders
/ epidemiology
Male
Postoperative Complications
/ drug therapy
Prevalence
Retrospective Studies
Risk Factors
TOR Serine-Threonine Kinases
/ antagonists & inhibitors
Tacrolimus
/ therapeutic use
Treatment Outcome
Viremia
/ epidemiology
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:
01 01 2021
01 01 2021
Historique:
received:
14
05
2020
accepted:
24
08
2020
pubmed:
17
10
2020
medline:
5
2
2021
entrez:
16
10
2020
Statut:
ppublish
Résumé
To describe the clinical and laboratory profile, natural course, treatment outcome, and risk factors of posttransplant esophageal and nonesophageal eosinophilic gastrointestinal disorders (EGIDs). All children (aged <18 years) who underwent liver transplantation, between 2011 and 2019, in a single transplant center with a follow-up period of 1 year or more posttransplant and with a history of posttransplant endoscopic evaluation were included in this study. During the study period, 89 children met the inclusion criteria. Patients were followed for a median of 8.0 years. A total of 39 (44%) patients were diagnosed with EGID after transplantation. Of these, 29 (33%) had eosinophilic esophagitis (EoE), and 10 (11%) had eosinophilic gastritis, gastroenteritis or enterocolitis. In comparison with the non-EGID group, patients with EGID were younger at transplant (P ≤ 0.0001), transplanted more frequently due to biliary atresia (P ≤ 0.0001), and had higher rates of pretransplant allergy (P = 0.019). In the posttransplant period, they had higher rates of mammalian Target of Rapamycin inhibitor use (P = 0.006), Epstein-Barr virus viremia (P = 0.03), post-transplant lymphoproliferative disease (P = 0.005), and allergen sensitization (P ≤ 0.0001). In regression analysis, young age at transplant, age at diagnosis, pretransplant atopic dermatitis, and post-transplant lymphoproliferative disease were associated with an increased risk of EGID or EoE. Laboratory abnormalities such as anemia (P = 0.007), thrombocytosis (P = 0.012), and hypoalbuminemia (P = 0.031) were more commonly observed in the eosinophilic gastritis, gastroenteritis or enterocolitis group than in the EoE group. Following treatment, most patients had symptomatic resolution at 3 months and histologic resolution at 6 months postdiagnosis. Among the patients who had 5 years of follow-up, none recurred. EGID is a common posttransplant diagnosis, which seems to affect patients who are transplanted earlier and who have pretransplant atopy. Posttransplant EGID is responsive to treatment, but as histologic remission occurs after symptomatic resolution, the decision to perform control endoscopy should be delayed.
Identifiants
pubmed: 33065587
pii: 00000434-202101000-00031
doi: 10.14309/ajg.0000000000000934
doi:
Substances chimiques
Anti-Allergic Agents
0
Glucocorticoids
0
Immunosuppressive Agents
0
Budesonide
51333-22-3
TOR Serine-Threonine Kinases
EC 2.7.11.1
Tacrolimus
WM0HAQ4WNM
Ketotifen
X49220T18G
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
188-197Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 by The American College of Gastroenterology.
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