Variation in prevalence, diagnostic criteria, and initial management options for eosinophilic gastrointestinal diseases in the United States.
Variation in prevalence, diagnostic criteria, and initial management options for eosinophilic gastrointestinal diseases in the United States.
复制标题
DOI：
10.1097/mpg.0b013e3181eb5a9f
复制
发表时间：
2011-03
影响因子：
2.9
通讯作者：
Bonis PA
中科院分区：
文献类型：
--
作者：
Spergel JM;Book WM;Mays E;Song L;Shah SS;Talley NJ;Bonis PA
不同地理区域嗜酸性胃肠道疾病患病率的差异尚未得到广泛研究。本研究的目的是确定区域和国家嗜酸性粒细胞胃肠道疾病的患病率以及实践方法的差异。我们以电子方式向美国胃肠病学会、美国过敏、哮喘和免疫学学会以及北美儿科胃肠病学、肝病学和营养学会的成员进行了一项调查。问题涉及嗜酸性粒细胞性胃肠炎或结肠炎和嗜酸性粒细胞性食管炎（EoE）患者的数量和比例，以及用于诊断和治疗这些疾病的方法。共有 1836 名医生对 10,874 项请求做出了回应（17% 的回应）。根据我们美国样本的反应，我们估计 EoE 和嗜酸性胃肠炎或结肠炎的总体患病率分别为 52 和 28/100,000。与农村地区（0.36，P <0.0065）相比，城市（0.58）和郊区（0.44）的 EoE 患者负担更高，观察结果与其他过敏性疾病一致。按每10万人的患病率计算，东北地区的患病率也有所增加。用于诊断 EoE 的标准和初始治疗方案存在很大差异。只有三分之一的受访者报告使用了 2007 年共识文件中提出的诊断标准。 71% 和 35% 的受访者报告分别通过禁食或元素饮食治疗一些 EoE 患者。 EoE 在东北部各州和城市地区的诊断率更高。诊断标准和初始治疗方法存在相当大的差异，支持需要进行额外的临床试验和达成共识。
Variation in the prevalence of eosinophilic gastrointestinal diseases in different geographical regions has not been extensively studied. The aim of the present study was to define the regional and national prevalence of eosinophilic gastrointestinal diseases, and differences in practice approaches. We administered a survey electronically to members of the American College of Gastroenterology, the American Academy of Allergy, Asthma, and Immunology, and the North American Society Pediatric Gastroenterology, Hepatology, and Nutrition. Questions pertained to the number and proportion of patients seen with eosinophilic gastroenteritis or colitis and eosinophilic esophagitis (EoE), and methods used to diagnose and treat these conditions. A total of 1836 physicians responded from 10,874 requests (17% response). Extrapolating responses from our US sample, we estimated an overall prevalence of 52 and 28/100,000 for EoE and eosinophilic gastroenteritis or colitis. The patient burden of EoE is higher in urban (0.58) and suburban (0.44) compared with rural settings (0.36, P <0.0065), observations consistent with other allergic disorders. There was also increased prevalence in northeast region when calculated by prevalence per 100,000. There was considerable variability in criteria and initial treatment options used to diagnose EoE. Only one-third of respondents reported using diagnostic criteria proposed in a 2007 consensus document. Seventy-one and 35% of respondents reported treating some patients with EoE with a food elimination or elemental diet, respectively. EoE is diagnosed more often in northeastern states and urban areas. There is considerable variability in diagnostic criteria and initial treatment approach supporting the need for additional clinical trials and consensus development.