Eosinophilic gastrointestinal disease and inflammatory bowel disease in children

Mutalib, Mohamed; Blackstock, Sarah; Evans, Victoria; Huggett, B.; Chadokufa, S.; Kiparissi, F.; Elawad, Mamoun

doi:10.1097/meg.0000000000000230

Cited by 13 publications

(10 citation statements)

References 12 publications

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“…There are two case series in the literature that report patients initially diagnosed with eosinophilic colitis who did not respond to treatment (elimination diet, anti-histamines, mast cell stabilizers, antibiotics) and who were subsequently histologically diagnosed as having UC [ 52 ] or CD [ 53 ]. EGEs and IBD might be two distinct disorders with different diagnostic criteria but common clinical manifestations and overlapping pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic gastrointestinal disorder: is it what it seems to be?

Zammit

Cachia

Sapiano

et al. 2018

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Background:Eosinophilic gastroenteropathy is an uncommon condition whose causes can be numerous and non-specific. The aim of the study was to characterize the presence of gastrointestinal disorders in the adult Maltese population and assess the degree of association with atopic diseases.Methods:Adult patients with gastrointestinal eosinophilia in the gastrointestinal tract on histology were identified and their clinical case notes were reviewed. Patients were interviewed and asked questions regarding asthma, allergic rhinitis, and eczema.Results:Sixty-six patients (39 female) were recruited. The most common clinical symptoms were diarrhea (42.4%) and abdominal pain (33.3%). The sites involved were stomach (10.6%), colon (56.1%), small bowel (10.6%), small bowel and colon (18.2%), esophagus (1.5%), and esophagus and colon (1.5%). Forty percent had persistent lower gastrointestinal symptoms and a repeat ileocolonoscopy was performed within 12 months. These patients were diagnosed with ulcerative colitis (n=10; 47.6%), Crohn’s disease (n=6; 28.6%), indeterminate colitis (n=1; 4.8%) or microscopic colitis (n=4; 19%). Allergic rhinitis was present in 39.4% of the study group, eczema in 26.1%, and asthma in 19.7%. These findings were compared with local data for atopic conditions and the study group was found to have a significantly higher prevalence of allergic rhinitis (P=0.002), but not of asthma (P=0.62) or eczema (P=0.19).Conclusions:A high proportion of patients with eosinophilic gastrointestinal infiltration were subsequently diagnosed with inflammatory bowel disease. Patients persistently symptomatic or who do not respond to treatment should be reassessed to exclude inflammatory bowel disease, given its high prevalence in this group of patients.

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Section: Discussionmentioning

confidence: 99%

Eosinophilic gastrointestinal disorder: is it what it seems to be?

Zammit

Cachia

Sapiano

et al. 2018

aog

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“…These results might be attributed to the polarization of the immune response toward Th2 cytokines by helminths downregulated or altered protective Th1 cytokine responses [24]. In general, gastrointestinal nematodes are linked to the Th2-type lymphocyte response, including secretion of the following cytokines: IL-4, IL-5, and IL-13 [25]. …”

Section: Discussionmentioning

confidence: 99%

Th1/Th2 balance and humoral immune response to potential antigens as early diagnostic method of equine Strongylus nematode infection

et al. 2017

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Aim::The aim of this study was to investigate the early diagnosis of strongyle infection based on early changes in Th1 and Th2 cytokines beside the diagnostic accuracy values and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and western blotting profiles using prepared strongyles antigens.Materials and Methods::A total of 73 donkeys had a mean age of 4-32 years old were parasitologically examined for strongyle infection. The early changes in Th1 and Th2 cytokines were determined, and the diagnostic accuracy values and SDS-PAGE and western blotting profiles were performed using prepared strongyles antigens; crude somatic Strongylus vulgaris (CSS), excretory-secretory S. vulgaris (ESS), crude somatic Cyathostomins (CSC), and excretory-secretory Cyathostomins (ESC).Results::The results revealed highest 437.04% and lowest 37.81% immunoglobulin G (IgG) in high and low egg shedder groups when using ESC and CSS antigens, respectively. Antibodies index for ESS and CSC were significantly higher in moderate egg shedder group while that for ESS and CSC, ESC was significantly higher in high egg shedder group. Tumor necrosis factor alpha (TNF-α)/interleukin-4 (IL-4) balance in S. vulgaris infected donkeys was approximately equal in apparently healthy, low and high egg shedder groups while TNF-α < IL-4 in moderate egg shedder. In Cyathostomins infected animals, TNF-α/IL-4 balance was approximately equal in apparently healthy group while it was low in moderate and high egg shedder groups. The diagnostic accuracy showed that the higher specificity (46.6%) and prevalence (95.40%) were recorded by CSS and ESC antigens, respectively. However, SDS-PAGE and western blotting profiling proved that the band at molecular weight 25 kDa is exhibited by CSS antigen.Conclusion::Combination of detecting level of TNF-α/IL-4 balance, CSS antigen and IgG concentration is good tool for appropriate diagnosis of such infection. More advancement research must be done concerning Th1/Th2 balance and cross-reactivity of S. vulgaris and Cyathostomins spp. at the base of serological and molecular investigation.

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“…The EIM for patients with UC and CD were being underweight, and having oral ulcers and arthritis. Diarrhea, abdominal pain, being underweight, oral ulcers and arthritis are symptoms of IBD (23)(24)(25). Patients with CD presented a higher proportion of immunoglobulin G, C-reactive protein and erythrocyte sedimentation rate compared with patients with UC.…”

Section: Discussionmentioning

confidence: 99%