Eosinophilic Esophagitis in Adults Lacks Seasonal Correlation

Karakelides, Martha; Kopacova, Jana; Enders, Felicity; Dierkhising, Ross A.; Talley, Nicholas J.; Weiler, Catherine R.; Alexander, Jeffrey L.

doi:10.14309/00000434-200910003-00004

Cited by 2 publications

(3 citation statements)

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“…There is a known male predominance of EoE in the general population, although why this discrepancy exists is not known. In larger investigations of EoE patients, 70–85% of the patient population are men . Anecdotally, we noted less of a male predominance in our clinical practice.…”

Section: Introductionmentioning

confidence: 51%

“…In larger investigations of EoE patients, 70-85% of the patient population are men. [6][7][8][9][10] Anecdotally, we noted less of a male predominance in our clinical practice. We therefore designed a casecontrol study to compare the initial presentation of EoE between genders.…”

Section: Introductionmentioning

confidence: 56%

“…Karakelides et al . described one of the largest cohorts of EoE patients at the Mayo Clinic, with 73% of 372 patients being male. Dellon et al ., in a study that investigated predictors of EoE, described 151 cases of EoE and noted that 77% were male .…”

Section: Discussionmentioning

confidence: 99%

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Gender is a determinative factor in the initial clinical presentation of eosinophilic esophagitis

Lynch

Dhalla

Ravich

et al. 2016

Diseases of the Esophagus

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Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease resulting in symptoms of esophageal dysmotility. Abnormalities include dysphagia, food impaction and reflux. Although men appear to comprise a majority of the EoE population, few studies have directly assessed gender-associated clinical differences. The aim of this study is to identify the effect of gender on the initial clinical presentation of adult-onset EoE patients. We reviewed our electronic medical record database from January 2008 to December 2011 for adults diagnosed with EoE per the 2011 updated consensus guidelines. Patient demographics, presenting symptoms, endoscopy findings and complications were recorded. Proportions were compared using chi-squared analysis, and means were compared using the Student's t-test. A total of 162 patients met the inclusion criteria and 71 (44%) were women. Women were more likely to report chest pain (P = 0.03) and heartburn (P = 0.06), whereas men more commonly reported dysphagia (P = 0.04) and a history of food impaction (P = 0.05). Endoscopic findings were similar between groups. No patients suffered esophageal perforations. These data suggest that men report more fibrostenotic symptoms and women report more inflammatory symptoms at the time of diagnosis. There was no difference in endoscopic findings between genders. This is one of the only reviews comparing differences in clinical presentation, endoscopic findings and complications between gender for EoE. The current recommended guidelines state that any patient with symptoms of esophageal dysfunction should be biopsied for EoE. Our findings support biopsying patients with typical and atypical symptoms of dysmotility including heartburn and chest pain.

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Section: Introductionmentioning

confidence: 51%

Section: Introductionmentioning

confidence: 56%

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Gender is a determinative factor in the initial clinical presentation of eosinophilic esophagitis

Lynch

Dhalla

Ravich

et al. 2016

Diseases of the Esophagus

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The Prevalence and Diagnostic Utility of Endoscopic Features of Eosinophilic Esophagitis: A Meta-analysis

Kim¹,

Vance²,

Shaheen³

et al. 2012

Clinical Gastroenterology and Hepatology

298

269

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Background & Aims Endoscopic findings such as esophageal rings, strictures, narrow-caliber esophagus, linear furrows, white plaques, and pallor or decreased vasculature might indicate the presence of eosinophilic esophagitis (EoE). We aimed to determine the prevalence and diagnostic utility of endoscopic features of EoE. Methods We conducted a systematic review and meta-analysis. PubMed, EMBASE, and GI meeting abstracts were searched to identify studies that included ≥ 10 patients with EoE and reported endoscopic findings. Pooled prevalence, sensitivity, specificity, and predictive values were calculated using random- and mixed-effects models. Results The search yielded 100 articles and abstracts on 4678 patients with EoE and 2742 without (controls). In subjects with EoE, the overall pooled prevalence of esophageal rings was 44%, strictures 21%, narrow-caliber esophagus 9%, linear furrows 48%, white plaques 27%, and pallor/decreased vasculature 41%. Substantial heterogeneity existed among studies. Results from endoscopy examinations were normal in 17% of patients, but this number decreased to 7% when the analysis was limited to prospective studies (P<.05). Overall levels of sensitivity were modest, ranging from 15% to 48%, whereas levels of specificity were greater, ranging from 90% to 95%. Positive predictive values ranged from 51% to 73% and negative predictive values ranged from 74% to 84%. Conclusions There is heterogeneity among studies in the reported prevalence of endoscopic findings in patients with EoE, but in prospective studies, at least 1 abnormality was detected by endoscopy in 93% of patients. The operating characteristics of endoscopic findings alone are inadequate for diagnosis of EoE. Esophageal biopsies should be obtained from all patients with clinical features of EoE, regardless of the endoscopic appearance of the esophagus.

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Eosinophilic Esophagitis in Adults Lacks Seasonal Correlation

Cited by 2 publications

References 0 publications

Gender is a determinative factor in the initial clinical presentation of eosinophilic esophagitis

Gender is a determinative factor in the initial clinical presentation of eosinophilic esophagitis

The Prevalence and Diagnostic Utility of Endoscopic Features of Eosinophilic Esophagitis: A Meta-analysis

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