Extent of eosinophilic esophagitis predicts response to treatment.

Autor: Ghoz H; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States., Stancampiano FF; Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States., Valery JR; Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States., Nordelo K; Clinical Research Internship Study Program (CRISP), Mayo Clinic, Jacksonville, Florida, United States., Malviya B; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States., Lacy BE; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States., Francis D; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States., DeVault K; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States., Bouras E; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States., Krishna M; Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, United States., Palmer WC; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States.
Jazyk: angličtina
Zdroj: Endoscopy international open [Endosc Int Open] 2021 Aug; Vol. 9 (8), pp. E1234-E1242. Date of Electronic Publication: 2021 Jul 16.
DOI: 10.1055/a-1492-2650
Abstrakt: Background and study aim  The clinical impact of eosinophilic esophagitis (EoE) limited to the distal esophagus (Lim-EE) vs. diffuse involvement (Dif-EE) is unknown. This study compared clinical characteristics and outcomes of Lim-EE vs. Dif-EE. Patients and methods  This retrospective, single-center study of patients with EoE between December 2011 and December 2019 evaluated treatment response based on repeated pathology and/or clinical improvement using comparative statistics. Results  479 patients were identified (126 Lim-EE, 353 Dif-EE). Lim-EE patients had a higher incidence of endoscopically identified esophagitis (23.0 % vs. 14.7 %; P  = 0.04), were older (50.8 [SD 16.2] vs. 46.4 [SD 15.3] years; P  = 0.007), and were more likely to present with iron deficiency anemia (5.6 % vs. 1.7 %; P  = 0.05), dyspepsia (15.1 % vs. 8.8 %; P  = 0.06) or for Barrett's surveillance (10.3 % vs. 3.7 %; P  = 0.02). Patients with Dif-EE presented more frequently with dysphagia (57.2 % vs. 45.2 %; P  = 0.02). Both groups had similar proton pump inhibitor (87.2 % vs. 83.3 %; P  = 0.37) and steroid (12.8 % vs. 21.4 %; P  = 0.14) use. Patients with Lim-EE had a better clinicopathologic response (61.5 % vs. 44.8 %; P  = 0.009). On multivariate analysis, EoE extent predicted treatment response with an odds ratio of 1.89 (95 % confidence interval 1.13-3.20; P  = 0.02). However, treatment response based only on repeat biopsy results showed no statistical difference between Lim-EE (52.5 %) and Dif-EE (39.7 %; P  = 0.15). Conclusions  Lim-EE may represent a distinct phenotype separate from Dif-EE, with more overlap with gastroesophageal reflux disease and better treatment response.
Competing Interests: Competing interests The authors declare that they have no conflict of interest.
(The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze: MEDLINE
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