Natural History of Eosinophilic Gastroenteritis
Natural History of Eosinophilic Gastroenteritis
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DOI：
10.1016/j.cgh.2011.07.017
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发表时间：
2011-11-01
影响因子：
12.6
通讯作者：
Colombel, Jean-Frederic
中科院分区：
文献类型：
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作者：
de Chambrun, Guillaume Pineton;Gonzalez, Florent;Colombel, Jean-Frederic
背景与目的：嗜酸性胃肠炎是一种罕见的胃肠道疾病，对其自然病史知之甚少。我们确定了EGE患者的临床特征和长期结果。方法：我们回顾了1988年1月至2009年4月期间被诊断为EGE的43例患者的临床资料。排除其他嗜酸性胃肠道疾患后，按标准诊断。我们分析了最初的临床表现和长期结果的数据。结果：黏膜型、浆膜下型和肌型分别占44%、39%和12%。病变部位主要为十二指肠(62%)、回肠(72%)或结肠(88%)；较少发生在食道(30%)或胃(38%)。74%的病例出现血嗜酸性粒细胞增多(500个/mm(3))。40%的患者出现自发缓解；大多数接受治疗的患者(74%)接受了口服皮质类固醇，这在大多数情况下是有效的。经过平均13年(0.8-29年)的随访期，我们确定了三种不同的疾病进展过程：18名患者(42%；9名浆膜下疾病患者)最初出现病情而不复发，16名(37%)有多个病情并以完全缓解期(复发性疾病)分隔，9名(21%)有慢性病。结论：EGE的临床表现是不同的，组织学类型各不相同；大约40%的患者自发地解决了疾病，没有复发。大约50%的人患有更复杂的疾病，其特征是无法预测的复发和慢性病程。
BACKGROUND & AIMS: Eosinophilic gastroenteritis (EGE) is a rare gastrointestinal disorder; little is known about its natural history. We determined the clinical features and long-term outcomes of patients with EGE. METHODS: We reviewed files from 43 patients diagnosed with EGE who were followed from January 1988 to April 2009. The diagnosis was made according to standard criteria after other eosinophilic gastrointestinal disorders were excluded. We analyzed data on initial clinical presentation and long-term outcomes. RESULTS: EGE was classified as mucosal, subserosal, or muscular in 44%, 39%, and 12% of cases, respectively. Disease location was mostly duodenal (62%), ileal (72%), or colonic (88%); it was less frequently esophageal (30%) or gastric (38%). Blood eosinophilia (numbers >500/mm(3)) was observed in 74% of cases. Spontaneous remission occurred in 40% of patients; the majority of treated patients (74%) received oral corticosteroids, which were effective in most cases. After a median follow-up period of 13 years (0.8 - 29 years), we identified 3 different courses of disease progression: 18 patients (42%; 9 with subserosal disease) had an initial flare of the disease without relapse, 16 (37%) had multiple flares that were separated by periods of full remission (recurring disease), and 9 (21%) had chronic disease. CONCLUSIONS: The clinical presentation of EGE is heterogeneous and varies in histologic pattern; about 40% of patients resolve the disease spontaneously, without relapse. Approximately 50% have a more complex disease, which is characterized by unpredictable relapses and a chronic course.