Rapidly increasing prevalence of eosinophilic oesophagitis in Western Australia
Rapidly increasing prevalence of eosinophilic oesophagitis in Western Australia
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DOI：
10.1136/adc.2006.100974
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发表时间：
2006-12-01
影响因子：
5.2
通讯作者：
Forbes, D. A.
中科院分区：
文献类型：
--
作者：
Cherian, S.;Smith, N. M.;Forbes, D. A.
目的：评估嗜酸性食管炎在三级儿科胃肠病门诊人群中的患病率。方法：对1995、1999和2004年间由儿科胃肠病专家调查的西澳儿童食管炎进行回顾性调查。记录每个儿童的内窥镜下食道的肉眼外观、原始组织学发现和诊断。活检标本被盲目地重新评估，与最初的报告相比，重新编码了组织学诊断。结果：西澳大利亚州嗜酸性食管炎的患病率在1995-2004十年间有所增加，从每10 000名儿童中的0.05人上升到每10 000名儿童中的0.89人，食管炎的严重程度由炎症细胞数量和相关的炎症特征决定。被诊断为嗜酸性食管炎的儿童的平均年龄为78.9个月(6.58岁)，没有性别或社会经济地位倾向的相关易感性。几乎三分之一的病例在内窥镜检查中大体正常。所有最初诊断为嗜酸性食管炎的儿童每个高倍视野中有40个嗜酸性粒细胞。结论：在1995-2004十年间，嗜酸性食管炎的患病率确实有所增加，但诊断转变并不能解释这一现象。应在内窥镜检查时采集组织标本，以确认或排除嗜酸性食管炎的诊断。
Aim: To assess the prevalence of eosinophilic oesophagitis in a tertiary paediatric gastroenterology clinic population.Methods: A retrospective audit of Western Australian children investigated for oesophageal disease by paediatric gastroenterologists in the years 1995, 1999 and 2004. Macroscopic appearance of the oesophagus at endoscopy, original histological findings and diagnosis were recorded for each child. Biopsy specimens were blindly re-evaluated, with re-coded histological diagnoses compared with original reports. Age, sex and socioeconomic status were identified for each child.Results: The prevalence of eosinophilic oesophagitis in Western Australia increased over the decade 1995 - 2004, rising from 0.05 to 0.89 per 10 000 children, with a concomitant increase in the severity of oesophagitis as determined by inflammatory cell numbers and associated features of inflammation. Children diagnosed with eosinophilic oesophagitis had a median age of 78.9 months (6.58 years), with no associated predisposition by sex or socioeconomic status trend. Almost one third of cases were macroscopically normal at endoscopy. All children with an original diagnosis of eosinophilic oesophagitis had >= 40 eosinophils per high-power field.Conclusion: Over the decade 1995 - 2004, a true increase was seen in the prevalence of eosinophilic oesophagitis, not accounted for by diagnostic shift. Histological samples should be taken at endoscopy to confirm or exclude the diagnosis of eosinophilic oesophagitis.