Prevalence and concordant occurrence of esophageal, gastric, duodenal, and colonic eosinophilia

Abstract

Summary Eosinophilic esophagitis, gastritis, duodenitis, and colitis are rare diseases. Few studies have been able to accumulate sufficiently large number of patients to analyze their clinical epidemiology. The aim of the present epidemiologic study was to examine the prevalence and concordant occurrence of gastrointestinal (GI) eosinophilia. Using a database of histopathologic records, a cross-sectional study among 302,061 patients undergoing bidirectional endoscopy evaluated the concordant occurrence of esophageal, gastric, duodenal, and colonic eosinophilia. The prevalence rates (PRs) of GI eosinophilia were expressed per 1,000 study subjects with their 95% Poisson confidence intervals (CIs). The concordant occurrence of various forms of GI eosinophilia was compared to their overall occurrence in the study population by calculating odds ratios (ORs) and their 95% CI. The database contained 3,008 patients with esophageal eosinophilia (PR = 9.96, 9.61–10.32), 366 patients with gastric eosinophilia (1.21, 1.09–1.34), 10 patients with duodenal eosinophilia (0.03, 0.02–0.06), and 124 patients with colonic eosinophilia (0.41, 0.34–0.49). The occurrence of esophageal eosinophilia was associated with an increased occurrence of gastric eosinophilia (OR = 3.58, 2.06–6.23), duodenal (40.22, 12.61–128.31), and colonic eosinophilia (8.12, 4.26–15.49). Similarly, we also found statistically significant associations between gastric eosinophilia and duodenal or colonic eosinophilia, and between duodenal and colonic eosinophilia. In the adult, as in the pediatric population, patients with any type of GI eosinophilia are at an increased risk for simultaneously harboring eosinophilia at multiple sites of their GI tract. With the exception of esophageal eosinophilia, however, other forms of GI eosinophilia are rarely diagnosed.

Challenging assumptions about the demographics of eosinophilic gastrointestinal diseases: A systematic review

“…Of the 50 studies with documentation of demographic distribution of age, race, ethnicity, sex, gender, BMI, rural versus urban residence, or insurance status, 12 provided data to support comparison of the demographic distribution of individuals with an EGID to that of the underlying source population ( Table II ). 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 Six of these studies were conducted using pathology databases, 2 were conducted using claims data, 3 were conducted using electronic health record (EHR) data sources, and 1 was conducted from a population-based online survey. All but 2 studies were conducted in populations in the United States, with one study using pathology data from New Zealand 35 and another study using EHRs from Spain.…”

“…For the nonesophageal EGIDs, 2 studies provided sex or gender distribution data for both the EGID type examined and the source population. 33 , 38 Eosinophilic gastritis or gastric eosinophilia, eosinophilic gastroenteritis or duodenal eosinophilia, or eosinophilic colitis or colonic eosinophilia were examined, and with the exception of the Jensen et al 33 study (n = 11,569,217 in the source population), which reported a somewhat lower proportion of male patients for eosinophilic gastritis relative to the source population (38.6% vs 47.9%; P = .004), no significant differences were observed for sex or gender distribution ( Table II ).…”

Duodenitis eosinofílica asociada a alergia alimentaria debutando como dolor visceral agudo en un adulto con vitíligo: reporte de un caso

“…La duodenitis eosinofílica aislada tiene una prevalencia de 0,03 por cada 1000 registros de endoscopia bidireccional (12) . Se conoce poco sobre su fisiopatología, pero se considera que la respuesta CD4/Th2 ya sea mediada o no por IgE, así como las citoquinas y quimioquinas responsables del reclutamiento de eosinófilos entre ellas IL13, IL5 juegan un papel importante, la infiltración de eosinófilos en tejido y su degranulación lleva a fibrosis tisular, trombosis, vasculitis de pequeños vasos e inflamación persistente.…”

Evaluating Eosinophilic Colitis as a Unique Disease Using Colonic Molecular Profiles: A Multi-Site Study

“…esophageal eosinophils; the eosinophil level is highest in the ascending colon, tapers to lower levels in the recto-sigmoid colon, 20,21 and increases during inflammation in many conditions. 16 As eosinophil-rich inflammation is not exclusive to EoC, primary EoC is a diagnosis that can be made only after all other known causes for increased colonic mucosal eosinophils have been eliminated.…”