Mayu Yamamoto1, Saori Nagashima1, Yoshiyuki Yamada2, Takatsugu Murakoshi3, Yasuyuki Shimoyama4, Sakuma Takahashi5, Hideyuki Seki6, Takashi Kobayashi7, Yuichi Hara8, Hiromi Tadaki9, Norihisa Ishimura10, Shunji Ishihara10, Yoshikazu Kinoshita11, Hideaki Morita12, Yukihiro Ohya13, Hirohisa Saito12, Kenji Matsumoto14, Ichiro Nomura15. 1. Division of Eosinophilic Gastrointestinal Disorders, National Research Institute for Child Health and Development, Tokyo, Japan. 2. Division of Allergy and Immunology, Gunma Children's Medical Center, Gunma, Japan. 3. Department of Gastroenterology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 4. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Gunma, Japan. 5. Department of Gastroenterology, Kagawa Prefectural Central Hospital, Kagawa, Japan. 6. Department of Gastroenterology, KKR Sapporo Medical Center, Hokkaido, Japan. 7. Department of Gastroenterology, Fujita Health University Bantane Hospital, Aichi, Japan. 8. Department of Gastroenterology, Fukuoka Sanno Hospital, Fukuoka, Japan. 9. Department of Pediatrics, National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. 10. Department of Gastroenterology, Shimane University Hospital, Shimane, Japan. 11. Department of Gastroenterology, Shimane University Hospital, Shimane, Japan; Department of Medicine, Steel Memorial Hirohata Hospital, Himeji, Japan. 12. Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan. 13. Allergy Center, National Center for Child Health and Development, Tokyo, Japan. 14. Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan. Electronic address: matsumoto-k@ncchd.go.jp. 15. Division of Eosinophilic Gastrointestinal Disorders, National Research Institute for Child Health and Development, Tokyo, Japan; Allergy Center, National Center for Child Health and Development, Tokyo, Japan. Electronic address: nomura-i@ncchd.go.jp.
Abstract
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.
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.
Authors: Evan S Dellon; Nirmala Gonsalves; J Pablo Abonia; Jeffrey A Alexander; Nicoleta C Arva; Dan Atkins; Stephen E Attwood; Marcus K H Auth; Dominique D Bailey; Luc Biederman; Carine Blanchard; Peter A Bonis; Paroma Bose; Albert J Bredenoord; Joy W Chang; Mirna Chehade; Margaret H Collins; Carlo Di Lorenzo; Jorge Amil Dias; Ranjan Dohil; Christophe Dupont; Gary W Falk; Cristina T Ferreira; Adam T Fox; Robert M Genta; Thomas Greuter; Sandeep K Gupta; Ikuo Hirano; Girish S Hiremath; Jennifer L Horsley-Silva; Shunji Ishihara; Norihisa Ishimura; Elizabeth T Jensen; Carolina Gutiérrez-Junquera; David A Katzka; Paneez Khoury; Yoshikazu Kinoshita; Kara L Kliewer; Sibylle Koletzko; John Leung; Chris A Liacouras; Alfredo J Lucendo; Lisa J Martin; Emily C McGowan; Calies Menard-Katcher; David C Metz; Talya L Miller; Fouad J Moawad; Amanda B Muir; Vincent A Mukkada; Simon Murch; Quan M Nhu; Ichiro Nomura; Samuel Nurko; Yoshikazu Ohtsuka; Salvatore Oliva; Rok Orel; Alexandra Papadopoulou; Dhyanesh A Patel; Robert D Pesek; Kathryn A Peterson; Hamish Philpott; Philip E Putnam; Joel E Richter; Rachel Rosen; Melanie A Ruffner; Ekaterina Safroneeva; Philipp Schreiner; Alain Schoepfer; Shauna R Schroeder; Neil Shah; Rhonda F Souza; Stuart J Spechler; Jonathan M Spergel; Alex Straumann; Nicholas J Talley; Nikhil Thapar; Yvan Vandenplas; Rajitha D Venkatesh; Mario C Vieira; Ulrike von Arnim; Marjorie M Walker; Joshua B Wechsler; Barry K Wershil; Benjamin L Wright; Yoshiyuki Yamada; Guang-Yu Yang; Noam Zevit; Marc E Rothenberg; Glenn T Furuta; Seema S Aceves Journal: Clin Gastroenterol Hepatol Date: 2022-02-16 Impact factor: 13.576
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