CT imaging features of eosinophilic colitis in children

Brandon, Jonathan; Schroeder, Shauna; Furuta, Glenn T.; Capocelli, Kelley E.; Masterson, Joanne C.; Fenton, Laura Z.

doi:10.1007/s00247-012-2615-8

Cited by 18 publications

(8 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(53, 54) Here, using a new and more potent double-antibody eosinophil-targeted treatment, we reinforce our previous findings demonstrating the positive impact of single-antibody eosinophil-targeted treatment on ileal inflammation and remodeling. (7)…”

Section: Discussionsupporting

confidence: 88%

Eosinophils and IL-33 Perpetuate Chronic Inflammation and Fibrosis in a Pediatric Population with Stricturing Crohnʼs Ileitis

Masterson

Capocelli

Hosford

et al. 2015

Inflammatory Bowel Diseases

Self Cite

View full text Add to dashboard Cite

Background Fibrostenosis and stricture are well-recognized endpoints in Crohn’s disease (CD). We hypothesized that stricturing-CD is characterized by eosinophilia and epithelial-IL-33. We proposed that eosinophil exposure to IL-33 would perpetuate inflammatory chronicity and subsequent fibrostenosis. Methods We performed a retrospective study of 74 children with inflammatory and stricturing ileal-CD comparing clinicopathological features to immunohistochemical measures of eosinophilia and IL-33. To scrutinize eosinophil patterns we developed a novel eosinophil-peroxidase (EPX)-score encompassing number, distribution and degranulation. Human eosinophils and intestinal fibroblasts were cultured with IL-33 and IL-13 and inflammatory and remodeling parameters were assessed. Anti-eosinophil therapy was also administered to the Crohn’s-like ileitis model (SAMP1/SkuSlc). Results Our novel EPX-score was more sensitive than H&E-staining, revealing significant differences in eosinophil patterns, comparing inflammatory and stricturing pediatric CD. A significant relationship between ileal-eosinophilia and complicated clinical/histopathological phenotype including fibrosis was determined. IL-33 induced significant eosinophil EPX-secretion and IL-13 production. Exposure to eosinophils in the presence of IL-33, ‘primed’ fibroblasts to increase pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), eosinophil-associated chemokines (CCL24, CCL26) and IL-13Rα2 production. Production of fibrogenic molecules (collagen 1A2, fibronectin and periostin) increased following exposure of ‘primed’-fibroblasts to IL-13. Epithelial-IL-33 was increased in pediatric Crohn’s-ileitis and strongly associated with clinical and histopathological activity, ileal eosinophilia and complicated, fibrostenotic disease. SAMP1/SkuSlc eosinophil-targeted treatment resulted in significant improvements in inflammation and remodeling. Conclusions Our study of specimens from pediatric patients with ileal CD linked eosinophil patterns and IL-33 to fibrosis; and suggested these may contribute to the perpetuation of inflammation and subsequent stricture in pediatric CD.

show abstract

Section: Discussionsupporting

confidence: 88%

Eosinophils and IL-33 Perpetuate Chronic Inflammation and Fibrosis in a Pediatric Population with Stricturing Crohnʼs Ileitis

Masterson

Capocelli

Hosford

et al. 2015

Inflammatory Bowel Diseases

Self Cite

View full text Add to dashboard Cite

show abstract

“…In pediatric patients with EC, colonic wall thickening, predominantly cecal or mild to moderate terminal ileal thickening, may be seen on CT scan, often mimicking the findings of Crohn's disease [71].…”

Section: Radiographic Evaluationmentioning

confidence: 94%

Eosinophilic Gastroenteritis and Colitis: a Comprehensive Review

Uppal

Kreiger

Kutsch

2015

Clinic Rev Allerg Immunol

154

117

View full text Add to dashboard Cite

Eosinophilic gastrointestinal disorders, including eosinophilic esophagitis, gastroenteritis, and colitis, refer to a spectrum of clinical diseases that present with variable degrees of infiltration of the gastrointestinal tract by eosinophils in the absence of other known causes of tissue eosinophilia. Clinical symptoms and laboratory findings are usually non-specific and may or may not be accompanied by peripheral blood eosinophilia. The extent of eosinophilic infiltration of the gastrointestinal wall varies from mucosal to transmural and serosal involvement. Diagnosis requires presence of gastrointestinal symptoms, demonstration of gastrointestinal eosinophilia by biopsy, and exclusion of other known causes of tissue eosinophilia. Many studies have pointed toward the eosinophil as the major offender; however, the exact functional role of the eosinophil in the pathogenesis of eosinophilic gastrointestinal disorders remains unclear. The roles of T-helper-2 cytokines and other mediators, such as eotaxin-1 and interleukin-5, have gained significant importance in the pathobiology of eosinophilic gastrointestinal disorders. Current understanding of treatment is based on case reports and a few case series, as there is a lack of large prospective studies. Steroids are currently the mainstay of therapy, but the roles of other drugs such as leukotriene inhibitors, mast cell stabilizers, interleukin-5 inhibitors, and anti-immunoglobulin E, along with other targets in the immune pathway, are currently being explored.

show abstract

“…There are no specific imaging signs of EG. In most case reports, CT scan is the technique of choice [18][19][20][21]. As in its clinical presentation, the CT features of EG also vary according to the different layers of the GI tract involved: ulcers and polyps in the mucosal pattern, strictures and thickening in the muscular pattern, and ascites and omental involvement in the serosal pattern [10].…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Gastroenteritis with Appendix Involvement: Role of Intestinal Ultrasound

et al. 2019

View full text Add to dashboard Cite

Eosinophilic gastroenteritis (EG) is a rare condition characterized by patchy eosinophilic inflammation of one or more layers of the gastrointestinal tract with no secondary causes of eosinophilia. EG is a treatable disease and, generally, patients show a positive response to steroid therapy. Sometimes the disease can present as acute abdomen, and appendicular involvement has seldom been described in the course of EG. In our case report we aimed to emphasize how useful gastrointestinal ultrasound is as a valuable tool for diagnosing and monitoring intestinal involvement during EG, avoiding invasive tests and unnecessary surgery.

show abstract

CT imaging features of eosinophilic colitis in children

Cited by 18 publications

References 13 publications

Eosinophils and IL-33 Perpetuate Chronic Inflammation and Fibrosis in a Pediatric Population with Stricturing Crohnʼs Ileitis

Eosinophils and IL-33 Perpetuate Chronic Inflammation and Fibrosis in a Pediatric Population with Stricturing Crohnʼs Ileitis

Eosinophilic Gastroenteritis and Colitis: a Comprehensive Review

Eosinophilic Gastroenteritis with Appendix Involvement: Role of Intestinal Ultrasound

Contact Info

Product

Resources

About