Dissociation between symptoms and histological severity in pediatric eosinophilic esophagitis.
Dissociation between symptoms and histological severity in pediatric eosinophilic esophagitis.
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DOI：
10.1097/mpg.0b013e31817f0197
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发表时间：
2009-02
影响因子：
2.9
通讯作者：
Rothenberg ME
中科院分区：
文献类型：
--
作者：
Pentiuk S;Putnam PE;Collins MH;Rothenberg ME
嗜酸性食管炎（EE）患者症状与组织学严重程度之间的关系尚不清楚。我们创建了小儿EE症状评分（PEESS），并将结果与食管的组织学检查结果进行了比较。年龄在3-18岁之间，组织学诊断为EE或其父母的受试者完成了一项调查，评估其胃肠道症状的频率和严重程度。评分范围为0-98。食管活检标本中的嗜酸性粒细胞数量与PEESS相关。49名受试者完成了PEESS。症状评分与嗜酸性粒细胞峰值计数无关（r2=0.079）。新诊断、未接受治疗的EE受试者（N=15）的平均评分为24.7 ± 16.4，PEESS与食管远端嗜酸性粒细胞数量之间存在中度相关性（r2=0.37）。34例治疗患者的平均PEESS评分低于未治疗患者[15.6 ± 12.9。p=0.046]。无论治疗类型如何，组织学缓解的治疗患者的平均评分与活动性EE的治疗患者相同。腹痛是报告的最常见和最严重的症状。在组织学缓解的20/34例受试者（58.8%）中，17例（85%）继续报告症状，平均评分为17.4 ± 9.9（范围1-38）。3例活动性组织学EE患儿（10%）报告无症状。未治疗EE的儿童PEESS高于治疗组。尽管组织学缓解，但85%的EE患者症状持续存在，10%的活动性EE患者报告无症状。我们的数据表明儿童EE的症状和组织学之间的分离。
The relationship between patient symptoms and histological severity of Eosinophilic Esophagitis (EE) is not known. We created a pediatric EE symptom score (PEESS) and compared the results with histological findings in the esophagus. Subjects ages 3–18 years with a histologic diagnosis of EE or their parent completed a survey rating the frequency and severity of their gastrointestinal symptoms. Scores ranged from 0–98. Eosinophil numbers in esophageal biopsy specimens were correlated with the PEESS. Forty-nine subjects completed the PEESS. The symptom score did not correlate with the peak eosinophil count (r2=0.079). Newly diagnosed, untreated EE subjects (N=15) had a mean score of 24.7 ± 16.4 with a modest correlation between the PEESS and the number of eosinophils in the distal esophagus (r2=0.37). The mean PEESS score in the 34 treated patients was lower than in untreated patients [15.6 ± 12.9. p=0.046]. The mean score for treated patients in histologic remission was the same as treated patients with active EE, irrespective of treatment type. Abdominal pain was the most frequent and severe symptom reported. Of 20/34 subjects (58.8%) in histologic remission, 17 (85%) continued to report symptoms with a mean score of 17.4 ± 9.9 (range 1–38). Three children with active histologic EE (10%) reported no symptoms. Children with untreated EE had a higher PEESS than treated subjects. Symptoms persisted in 85% of EE patients despite histologic resolution and 10% with active EE reported no symptoms. Our data indicates a dissociation between symptoms and histology in pediatric EE.