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

Robert D. Pesek*, Craig C. Reed, Amanda B. Muir, Patricia C. Fulkerson, Calies Menard-Katcher, Gary W. Falk, Jonathan Kuhl, Ellen K. Martin, Adam Z. Magier, Faria Ahmed, Maureen Demarshall, Ankur Gupta, Jonathan Gross, Tokunbo Ashorobi, Christina L. Carpenter, Jeffrey P. Krischer, Nirmala Gonsalves, Jonathan M. Spergel, Sandeep K. Gupta, Glenn T. FurutaMarc E. Rothenberg, Evan S. Dellon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

108 Scopus citations

Abstract

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 for patients with EG, EGE, and EC.METHODS:In this retrospective study, data were collected from 6 centers in the Consortium of Eosinophilic Gastrointestinal Researchers from 2005 to 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 of 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. One hundred fifty-four subjects (41%) had eosinophilic inflammation outside of their primary disease location with the esophagus the second most common gastrointestinal (GI) segment involved. Multisite inflammation was more common in children than in adults (68% vs 37%; P < 0.001). Initial treatment patterns varied highly between centers. One hundred-nine subjects (29%) had follow-up within 6 months, and the majority had clinical, endoscopic, and histologic improvements.CONCLUSIONS:In this cohort, EG, EGE, and EC were diagnosed more frequently over time, and inflammation of GI segments outside the primary disease site co-occurrence of atopy was common with a lack of male predominance. Symptoms were similar between diseases, and initial treatment strategies were highly variable. Future investigation should assess the cause of the increased prevalence of eosinophilic GI disorders and prospectively assess outcomes to establish treatment algorithms.

Original languageEnglish (US)
Pages (from-to)984-994
Number of pages11
JournalAmerican Journal of Gastroenterology
Volume114
Issue number6
DOIs
StatePublished - Jun 1 2019

Funding

Guarantor of the article: Robbie D. Pesek, MD. Specific author contributions: R.D.P.: planning/conducting of study, collecting/interpreting data, anddrafting manuscript. This author has approved the final draft of the submitted manuscript. C.C.R.: planning/conducting of study, collecting/interpreting data, and drafting manuscript. This author has approved the final draft of the submitted manuscript. A.B.M.: planning/conducting of study, collecting/interpreting data, and drafting manuscript. This author has approved the final draft of the submitted manuscript. P.C.F.: planning/conducting of study, collecting/interpreting data, and drafting manuscript. This author has approved the final draft of the submitted manuscript. C.M.-K.: planning/conducting of study, collecting/interpreting data, and drafting manuscript. This author has approved the final draft of the submitted manuscript. G.W.F.: planning/conducting of study, collecting/interpreting data, and drafting manuscript. This author has approved the final draft of the submitted manuscript. J.K.: collecting/interpreting data. This author has approved the final draft of the submitted manuscript. E.K.M.: collecting/interpreting data. This author has approved the final draft of the submitted manuscript. A.Z.M.: collecting/interpreting data. This author has approved the final draft of the submitted manuscript. F.A.: collecting/interpreting data. This author has approved the final draft of the submitted manuscript. M.D.: Collecting/interpreting data. This author has approved the final draft of the submitted manuscript. A.G.: collecting/interpreting data. This author has approved the final draft of the submitted manuscript. J.G.: collecting/ interpreting data. This author has approved the final draft of the submitted manuscript. T.A.: collecting/interpreting data. This author has approved the final draft of the submitted manuscript. C.L.C.: planning/conducting of study. This author has approved the final draft of the submitted manuscript. J.P.K.: planning/conducting of study. This author has approved the final draft of the submitted manuscript. N.G.: planning/conducting of study; drafting of manuscript. This author has approved the final draft of the submitted manuscript. J.M.S.: Planning/conducting of study; drafting of manuscript. This author has approved the final draft of the submitted manuscript. S.K.: planning/conducting of study and drafting of manuscript. This author has approved the final draft of the submitted manuscript. G.T.F.: planning/conducting of study and drafting of manuscript. This author has approved the final draft of the submitted manuscript. M.E.R.: planning/conducting of study, collecting/ interpreting data, and drafting manuscript. This author has approved the final draft of the submitted manuscript. E.S.D.: planning/ conducting of study, collecting/interpreting data, and drafting manuscript. This author has approved the final draft of the submitted manuscript. Financial support: Support for this project was provided through a research training grant as part of the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR) (U54 AI117804). CEGIR is part of the Rare Disease Clinical Research Network (RDCRN), an initiative of the Office of Rare Diseases Research (ORDR), NCATS, and is funded through collaboration between NIAID, NIDDK, and NCATS. CEGIR is also supported by patient advocacy groups including APFED CURED and EFC. This project also received support from the National Institutes of Health T32 DK007634 (CCR). Potential competing interests: R.P.: Consultant for Allakos. Patricia Fulkerson: Grant funding from the NIH; Consultant for Genentech, Inc; Research support from Knopp Biosciences, LLC. G.F.: Research support from Shire, Celgene, Adare, Regeneron. Consulting for Shire. J.M.S.: Consultant for Regeneron, DBV Technology, Kaleo; Grant funding from DBV Technology, Aimmune Therapeutics, Food Allergy Research Education; Royalties from UpToDate. N.G.: Royalties from UpToDate; Advisory board for Allakos. S.K.G.: Consultant for Allakos, Abbott, QOL, Receptos; research support from Shire. G.F.: Founder of EnteroTrack; Consultant for Shire; Royalties from UpToDate. M.E.R.: Consultant for Pulm One, Spoon Guru, ClostraBio, Celgene, Shire, Astra Zeneca, GlaxoSmithKline, Allakos, Adare, Regeneron and Novartis and has an equity interest in the first 4 listed and Immune Pharmaceuticals, and royalties from reslizumab (Teva Pharmaceuticals), PEESSv2 (Mapi Research Trust) and UpToDate. M.E.R. is an inventor of patents owned by Cincinnati Children’s. E.D.: Consultant for Adare, Allakos, Alivio, Banner, Celgen/Receptos, Enumeral, GSK, Regeneron, Shire; Research

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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