Ikuo Hirano1, Margaret H Collins2, Eileen King3, Qin Sun3, Mirna Chehade4, J Pablo Abonia3,5, Peter A Bonis6, Kelly E Capocelli7, Evan S Dellon8, Gary W Falk9, Nirmala Gonsalves1, Sandeep K Gupta10, John Leung6, David Katzka11, Paul Menard-Katcher12, Paneez Khoury13, Amy Klion14, Vincent A Mukkada15, Kathryn Peterson15, Tetsuo Shoda5, Amanda K Rudman-Spergel16, Jonathan A Spergel17, Guang-Yu Yang1,18, Marc E Rothenberg3,5, Seema S Aceves19, Glenn T Furuta7. 1. Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. 2. Department of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 3. Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. 4. Mount Sinai Center for Eosinophilic Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 5. Division of Allergy and Immunology, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 6. Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts, USA. 7. Digestive Health Institute, Children's Hospital of Colorado, Gastrointestinal Eosinophilic Diseases Program, Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Colorado School of Medicine, Aurora, CO, USA. 8. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. 9. Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 10. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Riley Hospital for Children/Indiana University School of Medicine, and Community Health Network, Indianapolis, IN, USA. 11. Division of Gastroenterology, Mayo Clinic, Rochester, Minnesota, USA. 12. Division of Gastroenterology, University of Colorado, Denver, Colorado, USA. 13. Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, Maryland, USA. 14. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 15. Department of Gastroenterology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA. 16. Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA. 17. Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA, USA. 18. Division of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. 19. Department of Pediatrics and Medicine, University of California San Diego, San Diego, California, USA.
Abstract
INTRODUCTION: Eosinophilic gastritis (EG) is a chronic inflammatory disease of the stomach characterized by eosinophil-predominant gastric mucosal inflammation and gastrointestinal symptoms. The aim of this study was to prospectively evaluate endoscopic features in a large series of children and adults with EG to better understand the endoscopic manifestations and develop a standardized instrument for investigations. METHODS: Data were prospectively collected as part of the Consortium for Eosinophilic Gastrointestinal Disease Researchers, a national collaborative network. Endoscopic features were prospectively recorded using a system specifically developed for EG, the EG Endoscopic Reference System (EG-REFS). Correlations were made between EG-REFS and clinical and histologic features. RESULTS: Of 98 patients with EG, 65 underwent assessments using EG-REFS. The most common findings were erythema (72%), raised lesions (49%), erosions (46%), and granularity (35%); only 8% of patients with active histology (≥30 eosinophils/high-power field) exhibited no endoscopic findings. A strong correlation between EG-REFS scores and physician global assessment of endoscopy severity was demonstrated (Spearman r = 0.84, P < 0.0001). The overall score and specific components of EG-REFS were more common in the antrum than in the fundus or body. EG-REFS severity was significantly correlated with active histology, defined by a threshold of ≥30 eosinophils/high-power field (P = 0.0002). DISCUSSION: Prospective application of EG-REFS identified gastric features with a strong correlation with physician global assessment of endoscopic activity in EG. Endoscopic features demonstrated greater severity in patients with active histology and a predilection for the gastric antrum. Further development of EG-REFS should improve its utility in clinical studies.
INTRODUCTION: Eosinophilic gastritis (EG) is a chronic inflammatory disease of the stomach characterized by eosinophil-predominant gastric mucosal inflammation and gastrointestinal symptoms. The aim of this study was to prospectively evaluate endoscopic features in a large series of children and adults with EG to better understand the endoscopic manifestations and develop a standardized instrument for investigations. METHODS: Data were prospectively collected as part of the Consortium for Eosinophilic Gastrointestinal Disease Researchers, a national collaborative network. Endoscopic features were prospectively recorded using a system specifically developed for EG, the EG Endoscopic Reference System (EG-REFS). Correlations were made between EG-REFS and clinical and histologic features. RESULTS: Of 98 patients with EG, 65 underwent assessments using EG-REFS. The most common findings were erythema (72%), raised lesions (49%), erosions (46%), and granularity (35%); only 8% of patients with active histology (≥30 eosinophils/high-power field) exhibited no endoscopic findings. A strong correlation between EG-REFS scores and physician global assessment of endoscopy severity was demonstrated (Spearman r = 0.84, P < 0.0001). The overall score and specific components of EG-REFS were more common in the antrum than in the fundus or body. EG-REFS severity was significantly correlated with active histology, defined by a threshold of ≥30 eosinophils/high-power field (P = 0.0002). DISCUSSION: Prospective application of EG-REFS identified gastric features with a strong correlation with physician global assessment of endoscopic activity in EG. Endoscopic features demonstrated greater severity in patients with active histology and a predilection for the gastric antrum. Further development of EG-REFS should improve its utility in clinical studies.
Authors: Ikuo Hirano; Nelson Moy; Michael G Heckman; Colleen S Thomas; Nirmala Gonsalves; Sami R Achem Journal: Gut Date: 2012-05-22 Impact factor: 23.059
Authors: Julie M Caldwell; Margaret H Collins; Emily M Stucke; Philip E Putnam; James P Franciosi; Jonathan P Kushner; J Pablo Abonia; Marc E Rothenberg Journal: J Allergy Clin Immunol Date: 2014-09-15 Impact factor: 10.793
Authors: Tetsuo Shoda; Ting Wen; Julie M Caldwell; Margaret H Collins; John A Besse; Garrett A Osswald; J Pablo Abonia; Nicoleta C Arva; Dan Atkins; Kelley E Capocelli; Evan S Dellon; Gary W Falk; Nirmala Gonsalves; Sandeep K Gupta; Ikuo Hirano; Vincent A Mukkada; Philip E Putnam; Rachel M Sheridan; Amanda K Rudman Spergel; Jonathan M Spergel; Joshua B Wechsler; Guang-Yu Yang; Seema S Aceves; Glenn T Furuta; Marc E Rothenberg Journal: J Allergy Clin Immunol Date: 2019-11-16 Impact factor: 10.793
Authors: Robert D Pesek; Craig C Reed; Amanda B Muir; Patricia C Fulkerson; Calies Menard-Katcher; Gary W Falk; Jonathan Kuhl; Ellen K Martin; Adam Z Magier; Faria Ahmed; Maureen Demarshall; Ankur Gupta; Jonathan Gross; Tokunbo Ashorobi; Christina L Carpenter; Jeffrey P Krischer; Nirmala Gonsalves; Jonathan M Spergel; Sandeep K Gupta; Glenn T Furuta; Marc E Rothenberg; Evan S Dellon Journal: Am J Gastroenterol Date: 2019-06 Impact factor: 10.864
Authors: Sandeep K Gupta; Gary W Falk; Seema S Aceves; Mirna Chehade; Margaret H Collins; Evan S Dellon; Nirmala Gonsalves; Ikuo Hirano; Vincent A Mukkuda; Kathryn A Peterson; Jonathan Spergel; Guang-Yu Yang; Glenn T Furuta; Marc E Rothenberg Journal: Gastroenterology Date: 2018-11-17 Impact factor: 22.682
Authors: Margaret H Collins; Lisa J Martin; Ting Wen; Juan Pablo Abonia; Philip E Putnam; Vincent A Mukkada; Marc E Rothenberg Journal: J Pediatr Gastroenterol Nutr Date: 2020-05 Impact factor: 2.839
Authors: Katherine Cheng; Sandeep K Gupta; Susanna Kantor; Jonathan T Kuhl; Seema S Aceves; Peter A Bonis; Kelley E Capocelli; Christina Carpenter; Mirna Chehade; Margaret H Collins; Evan S Dellon; Gary W Falk; Rashmi Gopal-Srivastava; Nirmala Gonsalves; Ikuo Hirano; Eileen C King; John Leung; Jeffrey P Krischer; Vincent A Mukkada; Alain Schoepfer; Jonathan M Spergel; Alex Straumann; Guang-Yu Yang; Glenn T Furuta; Marc E Rothenberg Journal: Transl Sci Rare Dis Date: 2017-12-18