Prospective Endoscopic Activity Assessment for Eosinophilic Gastritis in a Multisite Cohort.
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 03 2022
01 03 2022
Historique:
received:
21
03
2021
accepted:
27
12
2021
pubmed:
27
1
2022
medline:
29
4
2022
entrez:
26
1
2022
Statut:
ppublish
Résumé
Eosinophilic gastritis (EG) is a chronic inflammatory disease of the stomach characterized by eosinophil-predominant gastric mucosal inflammation and gastrointestinal symptoms. The aim of this study was to prospectively evaluate endoscopic features in a large series of children and adults with EG to better understand the endoscopic manifestations and develop a standardized instrument for investigations. Data were prospectively collected as part of the Consortium for Eosinophilic Gastrointestinal Disease Researchers, a national collaborative network. Endoscopic features were prospectively recorded using a system specifically developed for EG, the EG Endoscopic Reference System (EG-REFS). Correlations were made between EG-REFS and clinical and histologic features. Of 98 patients with EG, 65 underwent assessments using EG-REFS. The most common findings were erythema (72%), raised lesions (49%), erosions (46%), and granularity (35%); only 8% of patients with active histology (≥30 eosinophils/high-power field) exhibited no endoscopic findings. A strong correlation between EG-REFS scores and physician global assessment of endoscopy severity was demonstrated (Spearman r = 0.84, P < 0.0001). The overall score and specific components of EG-REFS were more common in the antrum than in the fundus or body. EG-REFS severity was significantly correlated with active histology, defined by a threshold of ≥30 eosinophils/high-power field (P = 0.0002). Prospective application of EG-REFS identified gastric features with a strong correlation with physician global assessment of endoscopic activity in EG. Endoscopic features demonstrated greater severity in patients with active histology and a predilection for the gastric antrum. Further development of EG-REFS should improve its utility in clinical studies.
Identifiants
pubmed: 35080202
doi: 10.14309/ajg.0000000000001625
pii: 00000434-202203000-00019
pmc: PMC8897269
mid: NIHMS1768706
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
413-423Subventions
Organisme : NIDDK NIH HHS
ID : P30 DK078392
Pays : United States
Organisme : NCATS NIH HHS
ID : U2C TR002818
Pays : United States
Organisme : NIAID NIH HHS
ID : U54 AI117804
Pays : United States
Informations de copyright
Copyright © 2022 by The American College of Gastroenterology.
Références
Pesek RD, Reed CC, Muir AB, et al. 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. Am J Gastroenterol 2019;114(6):984–94.
Jensen ET, Martin CF, Kappelman MD, et al. Prevalence of eosinophilic gastritis, gastroenteritis, and colitis: Estimates from a National Administrative Database. J Pediatr Gastroenterol Nutr 2016;62(1):36–42.
Ko HM, Morotti RA, Yershov O, et al. Eosinophilic gastritis in children: Clinicopathological correlation, disease course, and response to therapy. Am J Gastroenterol 2014;109(8):1277–85.
Reed C, Woosley JT, Dellon ES. Clinical characteristics, treatment outcomes, and resource utilization in children and adults with eosinophilic gastroenteritis. Dig Liver Dis 2015;47(3):197–201.
Kinoshita Y, Furuta K, Ishimaura N, et al. Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis. J Gastroenterol 2013;48(3):333–9.
Fujiwara Y, Tanoue K, Higashimori A, et al. Endoscopic findings of gastric lesions in patients with eosinophilic gastrointestinal disorders. Endosc Int Open 2020;8(12):E1817–25.
Lwin T, Melton SD, Genta RM. Eosinophilic gastritis: Histopathological characterization and quantification of the normal gastric eosinophil content. Mod Pathol 2011;24(4):556–63.
Pesek RD, Reed CC, Collins MH, et al. Association between endoscopic and histologic findings in a multicenter retrospective cohort of patients with non-esophageal eosinophilic gastrointestinal disorders. Dig Dis Sci 2020;65(7):2024–35.
Cheng K, Gupta SK, Kantor S, et al. Creating a multi-center rare disease consortium—The Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). Transl Sci Rare Dis 2017;2(3–4):141–55.
Shoda T, Wen T, Aceves SS, et al. Eosinophilic oesophagitis endotype classification by molecular, clinical, and histopathological analyses: A cross-sectional study. Lancet Gastroenterol Hepatol 2018;3(7):477–88.
Aceves SS, King E, Collins MH, et al. Alignment of parent- and child-reported outcomes and histology in eosinophilic esophagitis across multiple CEGIR sites. J Allergy Clin Immunol 2018;142(1):130–8.e1.
Gupta SK, Falk GW, Aceves SS, et al. Consortium of eosinophilic gastrointestinal disease researchers: Advancing the field of eosinophilic GI disorders through collaboration. Gastroenterology 2019;156(4):838–42.
Caldwell JM, Collins MH, Stucke EM, et al. Histologic eosinophilic gastritis is a systemic disorder associated with blood and extragastric eosinophilia, TH2 immunity, and a unique gastric transcriptome. J Allergy Clin Immunol 2014;134(5):1114–24.
Hirano I, Moy N, Heckman MG, et al. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: Validation of a novel classification and grading system. Gut 2013;62(4):489–95.
Gonsalves N. Eosinophilic gastrointestinal disorders. Clin Rev Allergy Immunol 2019;57(2):272–85.
Safroneeva E, Straumann A, Coslovsky M, et al. Symptoms have modest accuracy in detecting endoscopic and histologic remission in adults with eosinophilic esophagitis. Gastroenterology 2016;150(3):581–90.e4.
Collins MH, Martin LJ, Wen T, et al. Eosinophilic esophagitis histology remission score: Significant relations to measures of disease activity and symptoms. J Pediatr Gastroenterol Nutr 2020;70(5):598–603.
Nicodeme F, Hirano I, Chen J, et al. Esophageal distensibility as a measure of disease severity in patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol 2013;11(9):1101–7.e1.
Schoepfer AM, Straumann A, Panczak R, et al. Development and validation of a symptom-based activity index for adults with eosinophilic esophagitis. Gastroenterology 2014;147(6):1255–66.e21.
Sato M, Shoda T, Shimizu H, et al. Gene expression patterns in distinct endoscopic findings for eosinophilic gastritis in children. J Allergy Clin Immunol Pract 2017;5(6):1639–49.e2.
Shoda T, Wen T, Caldwell JM, et al. Molecular, endoscopic, histologic, and circulating biomarker-based diagnosis of eosinophilic gastritis: Multi-site study. J Allergy Clin Immunol 2020;145(1):255–69.