Gastrointestinal complications of inherited epidermolysis bullosa: cumulative experience of the National Epidermolysis Bullosa Registry.
BACKGROUND
Portions of the gastrointestinal (GI) tract may be severely involved in patients with inherited epidermolysis bullosa (EB). Evidence-based data are lacking as to the frequency and time of onset of these complications.


METHODS
Cross-sectional and longitudinal data were analyzed on 3,280 and 450 patients with EB, respectively, who were followed from 1986-2002 as part of the National EB Registry, an epidemiological study that attempted to identify, enroll, and collect data on every EB patient residing within the continental United States. Frequencies of abnormalities arising within the esophagus, stomach, small and large intestines, rectum, and anus were determined for each major EB subtype. Cumulative risks were similarly calculated for esophageal stenoses or strictures, and for severe growth retardation.


RESULTS
Esophageal strictures and growth retardation were commonly seen among the more severe EB subtypes, most notably Hallopeau-Siemens recessive dystrophic EB, and occurred as early as within the first year of life. EB subtype-specific differences were also observed in the frequency of occurrence of other GI complications.


CONCLUSIONS
A variety of GI complications arise in patients with inherited EB, varying across the major EB subtypes in their relative severity, frequency, and time of onset.


CONCLUSIONS
Data generated by the National EB Registry should provide a sound basis whereby evidence-based strategies can be implemented for more effective surveillance and treatment of specific GI complications.
Fine
Jo-David
JD
National Epidermolysis Bullosa Registry, and Department of Medicine (Dermatology), Vanderbilt University School of Medicine, Nashville, TN 37203, USA. jo-david.fine@vanderbilt.edu
Johnson
Lorraine B
LB
Weiner
Madeline
M
Suchindran
Chirayath
C
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004820:Epidermolysis Bullosa / Q000150:complications* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D012042:Registries; D012307:Risk Factors; D018571:Sentinel Surveillance; D012720:Severity of Illness Index; D014481:United States