title: Tissue and peripheral eosinophilia as predictors for disease outcome in children with ulcerative colitis.
abstract: BACKGROUND
  Eosinophils are implicated in the pathogenesis of ulcerative colitis.
  
  
  OBJECTIVE
  To evaluate the magnitude of mucosal and blood eosinophils in newly diagnosed pediatric ulcerative colitis patients and its significance in predicting disease outcomes.
  
  
  METHODS
  We retrospectively evaluated colorectal biopsies of 96 pediatric patients with ulcerative colitis and 50 age- and sex-matched controls. Samples were taken from diseased areas of the colon and examined by a gastrointestinal pathologist. The most inflamed site was used for assessment of mucosal eosinophils.
  
  
  RESULTS
  Samples from 96 diagnostic and 70 follow-up colonoscopies were evaluated. Median age was 13.3 years (IQR 10.1-15.3). Median duration of follow-up was 12.8 years (IQR 7.2-17.1). Median number of tissue eosinophils at diagnosis was 45 (IQR 22-73) compared to 10 eosinophils (IQR 8-25) during histologic remission (p<0.0001). Peripheral absolute eosinophil counts correlated with tissue inflammation and eosinophilia (p=0.001). Mucosal eosinophilic infiltration (p=0.02) and peripheral eosinophilia (p=0.04) was associated with clinical severity at diagnosis. Multivariate analysis showed that severe eosinophilic infiltration is associated with corticosteroid therapy following diagnosis (p=0.04) but not with long-term risk for step-up therapy or colectomy.
  
  
  CONCLUSIONS
  Tissue and peripheral eosinophilia correlate with ulcerative colitis severity at diagnosis and with short-term corticosteroid requirement but not with long-term outcomes.
authors.affiliation: Department of Pathology, Rabin Medical Center-Beilinson Campus, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. Electronic address: saramo@clalit.org.il.
authors.forename: Sara
authors.initials: S
authors.lastname: Morgenstern
authors.affiliation: Department of Pathology, Rabin Medical Center-Beilinson Campus, Petach Tikva, Israel. Electronic address: elenabr@clalit.org.il.
authors.forename: Elena
authors.initials: E
authors.lastname: Brook
authors.affiliation: Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Hospital, Petach Tikva, Israel. Electronic address: Firasytr@gmail.com.
authors.forename: Firas
authors.initials: F
authors.lastname: Rinawi
authors.affiliation: Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. Electronic address: shamirraanan@gmail.com.
authors.forename: Raanan
authors.initials: R
authors.lastname: Shamir
authors.affiliation: Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. Electronic address: dr.amit.assa@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Assa
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D003113:Colonoscopy; D004802:Eosinophilia / Q000453:epidemiology*; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D007557:Israel; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies
keywords: Colectomy; Eosinophil count; Histologic; Pediatric