Association Between Endoscopic and Histologic Findings in a Multicenter Retrospective Cohort of Patients with Non-esophageal Eosinophilic Gastrointestinal Disorders

Pesek, Robert D.; Reed, Craig C.; Collins, Margaret H.; Muir, Amanda B.; Fulkerson, Patricia C.; Menard‐Katcher, Calies; Falk, Gary W.; Kuhl, Jonathan; Magier, Adam; Ahmed, Faria; DeMarshall, Maureen; Gupta, Ankur; Gross, Jonathan; Ashorobi, Tokunbo; Carpenter, Christina; Krischer, Jeffrey P.; Gonsalves, Nirmala; Hirano, Ikuo; Spergel, Jonathan M.; Gupta, Sandeep K.; Furuta, Glenn T.; Rothenberg, Marc E.; Dellon, Evan S.

doi:10.1007/s10620-019-05961-4

Cited by 56 publications

(65 citation statements)

References 27 publications

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“…No association was observed between the endoscopic findings and gastric eosinophilic infiltration, and positive rate of gastric eosinophilia was similar between target and random biopsies. In this study, the mean gastric eosinophil count was 82 eos/hpf, which is similar to that reported in the study by Peresk et al (mean peak number: 78–87 eos/hpf) 19 . However, in the study by Peresk et al, gastric eosinophilia was reported to be mostly found in gastric mucosa with normal appearance.…”

Section: Discussionsupporting

confidence: 92%

“…They examined 376 patients with non-EoE EGIDs, which included 317 children, and EG was found in 142 patients and EGE in 123 patients. Gastric endoscopy performed on the 265 patients with EG or EGE revealed normal healthy mucosa in 169 patients (64 %), erythema in 52 (22 %), nodularity in 23 (9 %), and ulcer in 26 (10 %) [19]. The differences and similarities between our study and other studies may be due to race (Japanese/Asians or mostly Whites), age (adults only or predominantly children), and methodology (detailed analysis of endoscopic images or analysis of endoscopic records).…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic findings of gastric lesions in patients with eosinophilic gastrointestinal disorders

et al. 2020

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Background and study aims Eosinophilic gastrointestinal disorders are classified into eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, and eosinophilic colitis according to the site of eosinophilic infiltration. Although well established in eosinophilic esophagitis, endoscopic findings in eosinophilic gastritis and eosinophilic gastroenteritis with regard to gastric lesions have not been clearly described. The aim of this study was to identify endoscopic findings of gastric lesions associated with eosinophilic gastrointestinal disorders. Patients and methods Out of 278 patients with eosinophilic gastrointestinal disorders, 18 had eosinophilic gastritis or eosinophilic gastroenteritis confirmed by biopsy; their endoscopic images were analyzed retrospectively. The association between endoscopic findings and number of eosinophils in the gastric mucosa was investigated. Results Erythema was most frequently observed (72 %), followed by ulcers (39 %), discoloration (33 %), erosions (28 %), nodularity (28 %), and polyps (28 %). There were several unique endoscopic findings such as submucosal tumor-like deep large ulcers in three patients, antral Penthorum-like appearances (small nodules radially lined toward the pyloric ring) in three patients, “muskmelon-like appearances” (discolored mucosa-composed mesh pattern) in three patients, multiple white granular elevations in two patients, cracks (appearance of furrows similar to those in eosinophilic esophagitis) in five patients, and antral rings in one patient. No significant association was observed between endoscopic findings and number of gastric eosinophils. Conclusions Several unique endoscopic findings of gastric lesions were observed in patients with eosinophilic gastritis or eosinophilic gastroenteritis. Submucosal tumor-like ulcers, antral Penthorum-like appearances, muskmelon-like appearances, and cracks might be associated with eosinophilic gastrointestinal disorders.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Endoscopic findings of gastric lesions in patients with eosinophilic gastrointestinal disorders

et al. 2020

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“…Thus, the results of the endoscopic examination demonstrated that the lesion of the gastric and duodenal mucosa had no specific signs that would indicate food hypersensitivity. These data are confirmed by studies of some authors and indicate the need for histological examination [20]. However, despite this fact, there is a constant search for macroscopic changes in the mucous membrane of the gastrointestinal tract and their justification in terms of clinical, laboratory, and microscopic data, and it is proposed to take into account a number of features that are statistically significant [21,22].…”

Section: Figure 2 the Mucous Membrane Of The Gastric Antrum In A Child From Group 1 With Clinical Manifestations Of Food Hypersensitivitymentioning

confidence: 77%

1

Bubyr¹,

Kryuchko²,

Несіна³

et al. 2021

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Background. In pediatric practice, increasing attention has been recently paid to the study of allergic disorders in various parts of the gastrointestinal tract, and a number of unresolved issues regarding the timely diagnosis and treatment of eosinophilic lesions of the digestive system determines the relevance of this topic. The purpose of the research was to study the endoscopic and morphological changes of the upper gastrointestinal tract in children with gastrointestinal symptoms of food hypersensitivity. Materials and methods. The study enrolled 34 children aged from 6 to 15 years with clinical signs of disorders of the upper digestive tract against the background of food hypersensitivity reactions. Depending on the level of total IgE, study participants were divided into two groups. The first group consisted of 18 children with IgE-independent allergic reactions to food (Me (Q1-Q3) 35.0 (28.0–77.5)). The second group included 16 patients with IgE-induced allergic manifestations of food hypersensitivity (Me (Q1-Q3) 240.5 (158.0–475.8)). To achieve the aim of the research, all children underwent fibroesophagogastroduodenoscopy with subsequent sampling and morphological evaluation of biopsy specimen. Results. According to the results of endoscopic examination of patients, the structure of lesions of the upper gastrointestinal tract depending on the predominance of IgE-independent or IgE-mediated gastrointestinal symptoms of food hypersensitivity did not have statistically significant differences. Morphological characteristics had some differences in the study groups and were represented by the prevalence of eosinophilic infiltration in children with IgE-induced food hypersensitivity reactions. Conclusions. The isolated gastric lesions prevailed in the endoscopic presentation of children with gastrointestinal manifestations of food allergy, and morphological signs of chronic gastritis are characterized by changes in the surface epithelium due to pronounced polymorphonuclear inflammatory infiltration in the lamina propria with a predominance of lymphocytes, neutrophils and plasma cells. The degree of activity of the eosinophilic inflammatory process was more pronounced in the group of children with IgE-induced food hypersensitivity reactions (r = 0.652; p < 0.01).

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“…•For the diagnosis of eosinophilic gastroenteritis In contrast to eosinophilic esophagitis, no endoscopic abnormalities are detected in 60%-70% of patients with eosinophilic gastroenteritis, regardless of the gastrointestinal tract segment (47,48). Histological results often show dense eosinophil infiltration in these endoscopically normalappearing segments.…”

Section: Endoscopymentioning

confidence: 99%

Eosinophilic Gastrointestinal Diseases: The Pathogenesis, Diagnosis, and Treatment

Kinoshita

Yahata²,

Oouchi³

2023

Intern. Med.

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Eosinophilic gastrointestinal diseases are delayed-type chronic allergic disorders that show gastrointestinal eosinophil dense infiltration, with an exaggerated Th2-type immune reaction considered to be an important mechanism. These diseases can be roughly divided into two types: eosinophilic esophagitis, mainly found in young and middle-aged men, and eosinophilic gastroenteritis, which is found in both genders equally. A diagnosis of eosinophilic esophagitis is suspected when characteristic endoscopic findings, including longitudinal furrows and rings, are noted. However, characteristic endoscopic abnormalities are rarely found in cases with eosinophilic gastroenteritis, so multiple biopsy sampling from the apparently normal gastrointestinal mucosal surface is important for making an accurate diagnosis. The administration of systemic glucocorticoid is the standard treatment for eosinophilic gastroenteritis, while acid inhibitors and topical glucocorticoid swallowing therapy are effective for eosinophilic esophagitis. Anti-cytokine therapies for eosinophilic gastrointestinal diseases are currently under development.

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Association Between Endoscopic and Histologic Findings in a Multicenter Retrospective Cohort of Patients with Non-esophageal Eosinophilic Gastrointestinal Disorders

Cited by 56 publications

References 27 publications

Endoscopic findings of gastric lesions in patients with eosinophilic gastrointestinal disorders

Endoscopic findings of gastric lesions in patients with eosinophilic gastrointestinal disorders

1

Eosinophilic Gastrointestinal Diseases: The Pathogenesis, Diagnosis, and Treatment

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