Seasonal variation in detection of oesophageal eosinophilia and eosinophilic oesophagitis.
Seasonal variation in detection of oesophageal eosinophilia and eosinophilic oesophagitis.
复制标题
食管嗜酸性粒细胞和嗜酸性粒细胞炎的季节变化。
DOI：
10.1111/apt.13273
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发表时间：
2015-08
影响因子：
7.6
通讯作者：
Dellon ES
中科院分区：
文献类型：
--
作者：
Jensen ET;Shah ND;Hoffman K;Sonnenberg A;Genta RM;Dellon ES
据报道，嗜酸性食管炎（EoE）的诊断存在季节性变化，但研究结果并不一致，美国也没有全国性数据。为了确定在美国食管嗜酸性粒细胞增多症和EoE的诊断是否存在季节性变化，同时考虑到气候带和地理变化等因素。这是一项使用美国国家病理学数据库的横断面研究。食管嗜酸性粒细胞增多症患者（每个高倍视野≥15个嗜酸性粒细胞）构成主要病例定义，并与食管活检正常的患者进行比较。我们按季节和一年中的天数计算了食管嗜酸性粒细胞增多症的粗和调整后的几率。敏感性分析进行了更严格的情况下的EoE的定义，并分层后的气候带。本文分析了14,524例食管嗜酸性粒细胞增多症患者和90,459例正常人的临床资料。食管嗜酸性粒细胞增多症的校正比值在春末和夏季较高，7月的比值最高（aOR 1.13; 95%CI：1.03-1.24）。这些发现随着食管嗜酸性粒细胞增多水平的增加以及整个EOE病例定义而持续存在。季节变化最强的温带和寒冷的气候，和高峰诊断不同的气候区。食管嗜酸性粒细胞增多症和EoE的诊断有轻微但一致的季节性变化，夏季诊断病例更频繁。这些发现考虑了气候和地理差异，表明空气过敏原可能有助于疾病的发展或爆发。
Seasonal variation has been reported in diagnosis of eosinophilic esophagitis (EoE), but results are not consistent across studies and there are no national-level data in the United States. To determine if there is seasonal variation in diagnosis of esophageal eosinophilia and EoE in the U.S., while accounting for factors such as climate zone and geographic variation. This was a cross-sectional study using a U.S. national pathology database. Patients with esophageal eosinophilia (≥15 eosinophils per high-power field) comprised the primary case definition and were compared to those with normal esophageal biopsies. We calculated the crude and adjusted odds of esophageal eosinophilia by season, as well as by day of the year. Sensitivity analyses were performed using more restrictive case definitions of EoE, and after stratification by climate zone. 14,524 cases with esophageal eosinophilia and 90,459 normal controls were analyzed. The adjusted odds of esophageal eosinophilia were higher in the late spring and summer months, with the highest odds in July (aOR 1.13; 95%CI: 1.03–1.24). These findings persisted with increasing levels of esophageal eosinophilia, as well as across EoE case definitions. Seasonal variation was strongest in temperate and cold climates, and peak diagnosis varied by climate zone. There is a mild but consistent seasonal variation in the diagnosis of esophageal eosinophilia and EoE, with cases more frequently diagnosed during summer months. These findings take into account climate and geographic differences, suggesting that aeroallergens may contribute to disease development or flare.