Marie Lecouffe-Desprets1, Matthieu Groh2, Bruno Bour3, Claire Le Jeunne2, Xavier Puéchal4. 1. Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Descartes, National Referral Center for Rare Systemic and Autoimmune Diseases, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France; Hôtel-Dieu University Hospital, Department of Internal Medicine, 44000 Nantes, France. 2. Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Descartes, National Referral Center for Rare Systemic and Autoimmune Diseases, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France. 3. Le Mans General Hospital, Department of Gastroenterology, 72037 Le Mans, France. 4. Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Descartes, National Referral Center for Rare Systemic and Autoimmune Diseases, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France. Electronic address: xavier.puechal@aphp.fr.
Abstract
OBJECTIVES: To determine the clinical and pathological characteristics of eosinophilic gastrointestinal disease (EGID) associated with autoimmune connective tissue disease (CTD). METHODS: Systematic literature review. RESULTS: Twenty cases of CTD associated with EGID were identified. Systemic lupus erythematosus was the main EGID-associated CTD (35%), followed by rheumatoid arthritis (20%), systemic sclerosis or inflammatory myopathies (15%, each), and Sjögren's syndrome, scleromyositis or other overlapping connective tissue disease (5%, each). No patient had a history of atopy. In contrast with classical EGID among which eosinophilic esophagitis is the most frequent type, eosinophilic gastritis and/or enteritis represented 95% of cases. Gastrointestinal symptoms were often unspecific. Peripheral eosinophilia was found in 67% of cases. Upper and lower gastrointestinal endoscopy showed abnormal findings in only 40% and 30% of cases, respectively. EGID was confirmed by evidence of digestive eosinophilic infiltration, mainly in mucosal or submucosal layer. In all but one patient, the CTD was diagnosed prior to the occurrence of the EGID. In total, 95% of EGID had a favorable outcome, with corticosteroids being used in almost all cases. CONCLUSION: Clinicians should consider EGID as a possible diagnosis and perform gastrointestinal tract biopsies in patients with CTD presenting with gastrointestinal symptoms and unexplained eosinophilia. Conversely, more rarely extra-digestive features during follow-up in patients with EGID may lead to a diagnosis of an associated CTD. More research is needed to better understand the underlying pathophysiological processes leading to eosinophilic gastrointestinal infiltration in patients with CTD.
OBJECTIVES: To determine the clinical and pathological characteristics of eosinophilic gastrointestinal disease (EGID) associated with autoimmune connective tissue disease (CTD). METHODS: Systematic literature review. RESULTS: Twenty cases of CTD associated with EGID were identified. Systemic lupus erythematosus was the main EGID-associated CTD (35%), followed by rheumatoid arthritis (20%), systemic sclerosis or inflammatory myopathies (15%, each), and Sjögren's syndrome, scleromyositis or other overlapping connective tissue disease (5%, each). No patient had a history of atopy. In contrast with classical EGID among which eosinophilic esophagitis is the most frequent type, eosinophilic gastritis and/or enteritis represented 95% of cases. Gastrointestinal symptoms were often unspecific. Peripheral eosinophilia was found in 67% of cases. Upper and lower gastrointestinal endoscopy showed abnormal findings in only 40% and 30% of cases, respectively. EGID was confirmed by evidence of digestive eosinophilic infiltration, mainly in mucosal or submucosal layer. In all but one patient, the CTD was diagnosed prior to the occurrence of the EGID. In total, 95% of EGID had a favorable outcome, with corticosteroids being used in almost all cases. CONCLUSION: Clinicians should consider EGID as a possible diagnosis and perform gastrointestinal tract biopsies in patients with CTD presenting with gastrointestinal symptoms and unexplained eosinophilia. Conversely, more rarely extra-digestive features during follow-up in patients with EGID may lead to a diagnosis of an associated CTD. More research is needed to better understand the underlying pathophysiological processes leading to eosinophilic gastrointestinal infiltration in patients with CTD.
Authors: V N Nikolenko; M V Oganesyan; A D Vovkogon; Yu Cao; A A Churganova; M A Zolotareva; E E Achkasov; M V Sankova; N A Rizaeva; M Y Sinelnikov Journal: BMC Musculoskelet Disord Date: 2020-10-08 Impact factor: 2.362
Authors: Elizabeth T Jensen; Seema S Aceves; Peter A Bonis; Kimberly Bray; Wendy Book; Mirna Chehade; Margaret H Collins; Evan S Dellon; Gary W Falk; Nirmala Gonsalves; Sandeep K Gupta; Ikuo Hirano; David A Katzka; Shay Kyle; Denise Mack; Ellyn Kodroff; John Leung; Vincent A Mukkada; Melissa Scott; Ally Paliana; Kathleen Sable; Jonathan M Spergel; Mary Jo Strobel; Jeffrey Krischer; Marc E Rothenberg; Pablo Abonia Journal: J Pediatr Gastroenterol Nutr Date: 2020-10 Impact factor: 3.288