Peripheral eosinophilia and hypoalbuminemia are associated with a higher biopsy diagnostic yield for eosinophilic gastroenteritis

Brenner, Erica J.; Greenberg, Sydney B.; Chang, Nicole C.; Corder, S.R.; Cowherd, Ellen; Dellon, Evan S.

doi:10.1016/j.clinre.2021.101746

Cited by 10 publications

(12 citation statements)

References 21 publications

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“…[ 37 , 38 ] Therefore, biopsies are needed. A large retrospective study by Brenner et al [ 39 ] showed that the diagnostic rate of biopsy in EGE is low but substantially increases when combining with peripheral eosinophilia and hypoalbuminemia. Given its ability to affect different regions of the gastrointestinal tract and patchy distribution, full-range biopsies should be taken, regardless of where macroscopic lesions lie.…”

Section: Laboratory Findingsmentioning

confidence: 99%

Eosinophilic gastroenteritis: Pathogenesis, diagnosis, and treatment

Ruan

Liu

et al. 2023

Chinese Medical Journal

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Eosinophilic gastroenteritis (EGE) is a gastrointestinal disorder of unclear etiology that is characterized by eosinophilic infiltration of the stomach and small intestine, and consists of mucosal, muscular, and serosal subtypes. Eosinophilic infiltration of the gastrointestinal tract is a fundamental histopathological characteristic of EGE and is driven by several T-helper type 2 (Th2)-dependent cytokines and induced by food allergy. Due to the lack of a diagnostic gold standard, EGE has a high rate of delayed diagnosis or misdiagnosis. However, several new diagnostic strategies have been developed, such as novel genetic biomarkers and imaging tests. Although dietary therapy and corticosteroids remain the common choices for EGE treatment, recent decades have seen the emergence of novel treatment alternatives, such as biologics that target particular molecules involved in the pathogenic process. Preliminary investigations and clinical trials have demonstrated the efficacy of biologics and provided additional insights for the era of refractory or corticosteroid-dependent EGE biologics.

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Section: Laboratory Findingsmentioning

confidence: 99%

Eosinophilic gastroenteritis: Pathogenesis, diagnosis, and treatment

Ruan

Liu

et al. 2023

Chinese Medical Journal

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“…Another recent study demonstrated a higher diagnostic yield of biopsies for EoG when patients had peripheral eosinophilia and hypoalbuminemia. 121 As a general practice, biopsies for non-EoE EGIDs should be collected when there is a clinical suspicion for these disease pathologies based on symptomatology or if there are endoscopic abnormalities in the stomach. For example, if an index esophagogastroduodenoscopy is performed for the initial evaluation of dyspepsia, it would be clinically appropriate to collect gastric biopsies to assess for EoG.…”

Section: Eosinophilic Oesophagitismentioning

confidence: 99%

“…It is a reasonable approach to target abnormal tissue for all EGIDs. Another recent study demonstrated a higher diagnostic yield of biopsies for EoG when patients had peripheral eosinophilia and hypoalbuminemia 121 . As a general practice, biopsies for non‐EoE EGIDs should be collected when there is a clinical suspicion for these disease pathologies based on symptomatology or if there are endoscopic abnormalities in the stomach.…”

Section: Diagnosismentioning

confidence: 99%

Review article: Emerging insights into the epidemiology, pathophysiology, diagnostic and therapeutic aspects of eosinophilic oesophagitis and other eosinophilic gastrointestinal diseases

Low,

Dellon

2023

Aliment Pharmacol Ther

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SummaryBackgroundEosinophilic gastrointestinal diseases (EGIDs) are chronic, immune‐mediated disorders characterised clinically by gastrointestinal symptoms and histologically by a pathologic increase in eosinophil‐predominant inflammation in the gastrointestinal tract, in the absence of secondary causes of eosinophilia.AimsTo highlight emerging insights and research efforts into the epidemiology, pathophysiology, diagnostic and therapeutic aspects of eosinophilic oesophagitis (EoE) and non‐EoE EGIDs, and discuss key remaining knowledge gaps.MethodsWe selected and reviewed original research, retrospective studies, case series, randomised controlled trials, and meta‐analyses.ResultsStandardised nomenclature classifies EGIDs as EoE, eosinophilic gastritis (EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC). Incidence and prevalence of EoE are rising, emphasising the need to better understand how environmental risk factors and genetic features interact. Advances in understanding EoE pathophysiology have led to clinical trials of targeted therapy and the approval (in the United States) of dupilumab for EoE. Several therapies that are under investigation hope to satisfy both histologic and clinical targets. For non‐EoE EGIDs, efforts are focused on better defining clinical and histopathologic disease determinants and natural history, as well as establishing new therapies.ConclusionsUnmet needs for research are dramatically different for EoE and non‐EoE EGIDs. In EoE, non‐invasive diagnostic tests, clinicopathologic models that determine the risk of disease progression and therapeutic failure, and novel biologic therapies are emerging. In contrast, in non‐EoE EGIDs, epidemiologic trends, diagnostic histopathologic thresholds, and natural history models are still developing for these more rare disorders.

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“…The difficulty is that these symptoms are nonspecific, and more common conditions will be suspected before EGIDs. An elevated peripheral eosinophil count or low serum albumin can be helpful (7), but these are not present in all patients. Similarly, although EGIDs are believed to be allergic conditions, not all patients have atopy (6).…”

Section: Suspecting Nonspecific Symptomsmentioning

confidence: 99%

Eosinophilic Gastrointestinal Diseases Beyond Eosinophilic Esophagitis

Dellon

2022

Am J Gastroenterol

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The eosinophilic gastrointestinal diseases (EGIDs) are chronic, immune-mediated conditions characterized clinically by GI symptoms and histologically by pathologic infiltration of the GI tract by eosinophils. The most well-studied is eosinophilic esophagitis (EoE), but non-EoE EGIDs are becoming more frequently encountered. These have traditionally been classified by the predominant location inflammation, including eosinophilic gastritis (EoG; stomach only), eosinophilic enteritis (EoN; small bowel only), and eosinophilic colitis (EoC; colon only) (1,2). However, multiple locations can be involved (e.g., gastric and small bowel involvement), specific segments of the small bowel can be named (e.g., eosinophilic duodenitis [EoD]), and efforts are underway to standardize this nomenclature. The non-EoE EGIDs are considered rare diseases, with studies of administrative databases estimating the prevalence to be approximately 3-8/ 100,000 or ;50,000 cases in the United States (3). However, recent data suggest these conditions may be underdiagnosed (4). In this article, I will review my approach to the diagnosis and management of the non-EoE EGIDs, highlighting a number of principles that can be applied in most settings.

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Peripheral eosinophilia and hypoalbuminemia are associated with a higher biopsy diagnostic yield for eosinophilic gastroenteritis

Cited by 10 publications

References 21 publications

Eosinophilic gastroenteritis: Pathogenesis, diagnosis, and treatment

Eosinophilic gastroenteritis: Pathogenesis, diagnosis, and treatment

Review article: Emerging insights into the epidemiology, pathophysiology, diagnostic and therapeutic aspects of eosinophilic oesophagitis and other eosinophilic gastrointestinal diseases

Eosinophilic Gastrointestinal Diseases Beyond Eosinophilic Esophagitis

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