Increasing Rates of Diagnosis, Substantial Co-Occurrence, and Variable Treatment Patterns of Eosinophilic Gastritis, Gastroenteritis, and Colitis Based on 10-Year Data Across a Multicenter Consortium

Abstract

Objective: The literature related to eosinophilic gastritis (EG), gastroenteritis (EGE) and colitis (EC) is limited. We aimed to characterize rates of diagnosis, clinical features, and initial treatments of patients with EG, EGE, and EC. Methods: In this retrospective study, data were collected from six centers in the Consortium of Eosinophilic Gastrointestinal Researchers (CEGIR) from 2005-2016. We analyzed demographics, time trends in diagnosis, medical history, presenting symptoms, disease overlap, and initial treatment patterns/responses. Results: Of 373 subjects (317 children and 56 adults), 38% had EG, 33% EGE, and 29% EC. Rates of diagnosis for all diseases increased over time. There was no male predominance, and the majority of subjects had atopy. Presenting symptoms were similar between diseases with nausea/ vomiting and abdominal pain the most common. 154 subjects (41%) had eosinophilic inflammation outside of their primary disease location with the esophagus the most common second GI segment involved. Multi-site inflammation was more common in children than adults (68% vs 37%; p<0.001). Initial treatment patterns varied highly between centers. 109 subjects (29%) had follow-up within 6 months and the majority had clinical, endoscopic and histologic improvement.

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

“…We previously reported that treatments such as corticosteroids or food elimination improved clinical, endoscopic, and histologic outcome measures [16]. The current study examined the impact of treatment on specific endoscopic and histologic findings.…”

“…For this retrospective cohort study, centers from the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR) were asked to participate and 6 centers (4 pediatric and 2 pediatric/adult) submitted subjects for enrollment [15]. Complete methodology and clinical characteristics of the study cohort were described previously [16]. Briefly, subjects were considered eligible for study inclusion if they were seen at enrolling sites between 2005 and 2016, had a clinical diagnosis of EG, EGE (EG and eosinophilic enteritis), and/or EC, and at least one endoscopy with biopsy demonstrating an increase in gastrointestinal eosinophils.…”

“…1). Data on baseline population characteristics have been previously reported [16]. In brief, the overall age range of patients was 0.5-77 years.…”

Molecular, endoscopic, histologic, and circulating biomarker-based diagnosis of eosinophilic gastritis: Multi-site study

“…Eosinophilic gastritis (EG) is one of the eosinophilic gastrointestinal disorders (EGIDs) characterized by marked eosinophil accumulation into the gastrointestinal tract, 1,2 with an estimated prevalence of about 6.3 patients per 100,000 subjects, which is likely increasing. 3,4 Although studies of eosinophilic esophagitis (EoE) have elucidated specific molecular, cellular, and immune mechanisms involved in its pathogenesis, 5 EG is more rare than EoE and thus less well understood, with few publications even addressing diagnostic criteria, genetics, biomarkers, or disease pathogenesis. Unlike in the esophagus, eosinophils normally reside in the gastric mucosa during homeostasis, 6,7 adding complexity to disease diagnosis and monitoring.…”

Amassing Granular Information About Eosinophilic Gastrointestinal Disorders Through Multicenter Cooperation: A Paradigm for Rare Disease Study

“…The initial publication from this group reported that the rate of diagnosis of EGIDs has been increasing with a slight predominance of eosinophilic gastritis over that of enteritis and colitis [3]. More than a third of patients had eosinophilic inflammation outside of their primary disease location, most commonly within the esophagus.…”