Comparison of Nonesophageal Eosinophilic Gastrointestinal Disorders with Eosinophilic Esophagitis: A Nationwide Survey
Comparison of Nonesophageal Eosinophilic Gastrointestinal Disorders with Eosinophilic Esophagitis: A Nationwide Survey
复制标题
DOI：
10.1016/j.jaip.2021.06.026
复制
发表时间：
2021-09-07
影响因子：
9.4
通讯作者：
Nomura, Ichiro
中科院分区：
文献类型：
--
作者：
Yamamoto, Mayu;Nagashima, Saori;Nomura, Ichiro
背景：嗜酸性粒细胞性食管炎（EoE）迅速增加，并已得到很好的表征。然而，没有全国性的调查已经进行了关于非食管嗜酸性粒细胞性胃肠疾病（非EoE EGIDs），他们仍然知之甚少。目的：通过使用相同的问卷，为所有年龄段比较非EoE EGIDs和EoE的临床特征和自然病史。方法：我们进行了一项全国性的医院为基础的调查，从2013年1月到2017年12月访问医院的患者。我们随机选择了10，000家进行内窥镜检查的医院。我们分析了EoE和非EoE EGIDs.RESULTS的人口统计学、症状、胃肠道组织学、治疗和自然史，共有2906家医院回答了问卷。我们确定了1542例患者，并获得了786例患者的详细数据，包括39%的EoE和61%的非EoE EGID。分析符合排除合并症的“明确”标准的患者的临床特征。非EoE EGID显示没有性别差异，而EoE是男性占主导地位。组织嗜酸性粒细胞增多主要见于小肠（62%）和胃（49%）。儿童期低蛋白血症发生率高（27%）。儿童也比成人有更严重的症状和并发症：日常生活活动受限（P = 0.009），无法生长/体重减轻（P = 0.008）和手术（P = 0.01）。对于这两种疾病，最常见的自然史是连续型：66%（95%置信区间[CI]：58-74）在EoE和64%（95% CI：55-72）在non-EoE EGIDs.CONCLUSIONS：非EoE EGIDs的持续患者的百分比几乎与EoE相同。并发症在儿童中比在成人中更常见。(C)2021年美国过敏、哮喘和免疫学会
BACKGROUND: Eosinophilic esophagitis (EoE) has increased rapidly and has been well characterized. However, no nationwide survey has been conducted regarding non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs), and they remain poorly understood.OBJECTIVE: To compare the clinical features and natural histories of non-EoE EGIDs and EoE by using the same questionnaire, for all ages.METHODS: We conducted a nationwide hospital-based survey of patients who visited hospitals from January 2013 through December 2017. We randomly selected 10,000 hospitals that perform endoscopy. We analyzed the demographics, symptoms, gastrointestinal histology, treatments, and natural histories of EoE and non-EoE EGIDs.RESULTS: A total of 2906 hospitals responded to the questionnaire. We identified 1542 patients and obtained detailed data for 786 patients, consisting of 39% EoE and 61% non-EoE EGIDs. The clinical characteristics were analyzed for patients who met the "definite" criteria that excluded comorbidities. Non-EoE EGIDs showed no gender difference, whereas EoE was male-predominant. Tissue eosinophilia was often seen in the small intestine (62%) and stomach (49%). The frequency of hypoproteinemia was high (27%) in childhood. Children also had more serious symptoms and complications than adults: restriction of daily life activity (P = .009), failure to grow/weight loss (P = .008), and surgery (P = .01). For both diseases, the most common natural history was the continuous type: 66% (95% confidence interval [CI]: 58-74) in EoE and 64% (95% CI: 55-72) in non-EoE EGIDs.CONCLUSIONS: The percentage of persistent patients with non-EoE EGIDs was almost the same as those with EoE. Complications were more frequent in children than in adults. (C) 2021 American Academy of Allergy, Asthma & Immunology