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Non-esophageal eosinophilic gastrointestinal disorders: persistent and severe, especially in children

Published: June 29, 2021

Eosinophilic gastrointestinal disorders (EGIDs) are chronic inflammatory disorders of the gastrointestinal tract. There are 2 types of EGIDs: eosinophilic esophagitis (EoE), in which inflammation occurs only in the esophagus, and non-EoE EGIDs, in which inflammation occurs in other parts of the GI tract. Non-EoE EGIDs involve the organs vital for digestion and nutrient absorption, such as the stomach and intestines. There have been many studies on the pathogenesis and natural history of EoE, but few on non-EoE EGIDs. More information is needed to further understanding of non-EoE EGIDs.

In The Journal of Allergy and Clinical Immunology: In Practice, Yamamoto M et al. published the results of a nation-wide survey that compared non-EoE EGIDs with EoE. The study was conducted by sending a questionnaire to 10,000 medical institutions that perform gastrointestinal endoscopy throughout Japan. The questionnaire was the same for both EoE and non-EoE EGIDs, permitting direct comparison. To evaluate the natural course, the authors classified cases into single-flare, intermittent and continuous types.

They analyzed 153 patients with EoE and 151 patients with non-EoE EGIDs who fulfilled the respective clinical and pathological criteria. The 2 diseases were distinctly different. EoE was more common in males, with a peak age of onset in the 30-50 age group. Non-EoE EGIDs were similar in both sexes, with two peaks, one in the 5-17 age group and the other in adulthood. Restrictions of daily life (51%), growth retardation (7%) and hypoproteinemia (21%) were more common in non-EoE EGIDs than in EoE. With non-EoE EGIDs, restriction of daily life was most common in children (70%). The natural history was the continuous type in 66% of EoE patients, 64% of non-EoE EGID patients and 75% of child non-EoE EGID patients. This study revealed non-EoE EGIDs to be persistent and severe, especially in children. There is a need to develop treatments that have fewer long-term side effects and do not inhibit children’s growth.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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