Association of eosinophilic esophagitis with autoimmune and connective tissue disorders, and the impact on treatment response.
Association of eosinophilic esophagitis with autoimmune and connective tissue disorders, and the impact on treatment response.
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嗜酸性粒细胞性食管炎与自身免疫和结缔组织疾病的关联以及对治疗反应的影响。
DOI：
10.1093/dote/doac043
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Dellon,EvanS
中科院分区：
文献类型：
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作者：
Xue,Zeyun;Miller,TalyaL;Abramson,Lior;Thakkar,KisanP;Ketchem,CoreyJ;Reddy,Sumana;Greenberg,SydneyB;Abichandani,Sonia;Chang,NicoleC;Eluri,Swathi;Reed,CraigC;Dellon,EvanS
嗜酸性粒细胞性食管炎 (EoE) 与自身免疫 (AI) 和结缔组织疾病 (CTD) 相关，但对于患有这两种疾病的患者来说，临床相关性和对局部皮质类固醇 (tCS) 的治疗反应尚不清楚。我们的目的是确定 EoE 患者中 AI/CTD 的患病率和临床特征，并评估对 tCS 的反应。在这项针对北卡罗来纳大学 EoE 临床病理数据库中新诊断为 EoE 的成人和儿童的回顾性队列研究中，我们提取了临床特征和治疗反应数据。我们比较了有和没有 AI/CTD 的 EoE 患者，确定了独立的相关因素，并探讨了治疗反应。在 1029 名 EoE 患者中，61 名 (5.9%) 患有 AI/CTD。最常见的 AI/CTD 是银屑病/银屑病关节炎 (P/PA) (1.7%)、桥本氏病 (1.2%) 和类风湿性关节炎 (RA) (1%)。与没有 AI/CTD 的患者相比，AI/CTD 患者年龄更大（35 岁 vs. 28 岁，P= 0.004），更有可能是女性（51% vs. 30%，P= 0.001），有保险（93% vs. 78%，P= 0.004），并且 EoE 诊断前症状持续时间更长（10% vs. 10%）。 7 年，P= 0.02)。年龄较大、女性、有保险和患有过敏性鼻炎与 AI/CTD 独立相关。患有 EoE 的 AI/CTD 患者出现症状缓解的可能性较小（47% vs. 79%，P= 0.003）。 EoE 和 AI/CTD 之间的重叠并不常见，约为 6%，其中 P/PA、桥本和 RA 最常见。总之，年龄较大、女性、有保险和过敏性鼻炎与 AI/CTD 独立相关。患有 AI/CTD 的 EoE 患者对 tCS 治疗的症状反应较少，且内镜和组织学反应呈较低趋势。
Eosinophilic esophagitis (EoE) has been associated with autoimmune (AI) and connective tissue disorders (CTDs), but clinical correlates and treatment response to topical corticosteroids (tCS) for patients with both conditions are not well known. We aimed to determine the prevalence and clinical features of AI/CTDs in EoE patients, and assess the response to tCS. In this retrospective cohort study of adults and children newly diagnosed with EoE in the University of North Carolina EoE Clinicopathologic database, we extracted clinical characteristics and treatment response data. We compared EoE patients with and without AI/CTDs, identified independently associated factors, and explored treatment responses. Of 1029 EoE patients, 61 (5.9%) had an AI/CTDs. The most common AI/CTDs were psoriasis/psoriatic arthritis (P/PA) (1.7%), Hashimoto’s (1.2%), and rheumatoid arthritis (RA) (1%). Compared to those without AI/CTDs, AI/CTDs patients were older (35 vs. 28 years,P= 0.004), more likely to be female (51% vs. 30%,P= 0.001), have insurance (93% vs. 78%,P= 0.004) and a longer symptom duration prior to EoE diagnosis (10 vs. 7 years,P= 0.02). Older age, female sex, having insurance, and having allergic rhinitis were independently associated with AI/CTDs. AI/CTD patients with EoE were less likely to have a symptom response (47% vs. 79%,P= 0.003). Overlap between EoE and AI/CTDs was uncommon, seen in approximately 6%, with P/PA, Hashimoto’s, and RA being most frequent. In conclusion, older age, female sex, having insurance, and allergic rhinitis were independently associated with AI/CTDs. EoE patients with AI/CTDs had less symptom response, with trendtowards lower endoscopic and histologic responses, to tCS therapy.