A shift in the clinical spectrum of eosinophilic gastroenteritis toward the mucosal disease type.
OBJECTIVE
Eosinophilic gastroenteritis (EG) is a rare disorder characterized by eosinophilic infiltration of the gastrointestinal (GI) tract. Despite the increasing prevalence of eosinophilic GI disorders, the epidemiology of EG has not been well studied. We evaluated the clinical spectrum of EG.


METHODS
We reviewed data from patients diagnosed with EG, allergic gastroenteropathy, or eosinophilia and referred to gastroenterologists from 1987 to 2007 (n = 59; 52 with mucosal, 3 with muscularis, and 4 with subserosal disease). The study included subjects diagnosed with EG and those with a history that suggested EG, defined by GI symptoms; eosinophilic infiltration of the GI tract, eosinophilic ascites, or characteristic radiographic findings with eosinophilia; and no parasitic or extraintestinal disease. Findings were compared with those from patients with unexplained GI symptoms and peripheral eosinophilia (n = 11).


RESULTS
Associations between clinical variables and EG subgroups did not differ between patients with EG and peripheral eosinophilia. Fifty percent of patients with EG who underwent food allergy testing had a positive test result; only 32% of those with EG who underwent radiographic imaging had positive test results. Patients with EG received steroid therapy; 75% with mucosal, 67% with muscle, and 100% with subserosal disease received prednisone. Eighty-eight percent of patients who received only steroids (mean follow-up period, 7 mo) and 94% of patients who received steroids in combination with another therapy (mean follow-up period, 4 mo) had improved or resolved disease.


CONCLUSIONS
Unlike eosinophilic esophagitis, EG is rare. Results from this large study suggest that EG disease type has shifted toward that of the mucosal layer.
Chang
Joseph Y
JY
Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Choung
Rok Seon
RS
Lee
Ru Min
RM
Locke
G Richard
GR
Schleck
Cathy D
CD
Zinsmeister
Alan R
AR
Smyrk
Thomas C
TC
Talley
Nicholas J
NJ
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001201:Ascites / Q000473:pathology; D004802:Eosinophilia / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005759:Gastroenteritis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D006651:Histocytochemistry; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D015994:Incidence; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology; D007583:Jejunum / Q000473:pathology; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D011860:Radiography, Abdominal; D013256:Steroids / Q000627:therapeutic use; D013270:Stomach / Q000473:pathology; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D007155:Immunologic Factors; D013256:Steroids