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Du N, Torres C. Prevalence of eosinophilic gastrointestinal diseases in children with short bowel syndrome: A single center study. J Pediatr Gastroenterol Nutr 2024. [PMID: 38511559 DOI: 10.1002/jpn3.12191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024]
Abstract
Patients with short bowel syndrome (SBS) have multiple risk factors for eosinophilic gastrointestinal diseases (EGIDs) including increased risk for intestinal dysbiosis and food allergy compared to their counterparts with normal anatomy. However, there is limited data on the prevalence of EGIDs in children with SBS. We aimed to define the prevalence of EGIDs in an SBS cohort and its association with different risk factors via a retrospective chart review of patients with SBS at Children's National Hospital. The prevalence of eosinophilic esophagitis in our SBS cohort was 10%, eosinophilic gastritis was 4.9%, and eosinophilic enteritis was 4.9%. SBS patients with history of allergy or atopy were more likely to have esophageal and intestinal eosinophilia on biopsy than patients without allergy. The prevalence of EGIDs in our SBS cohort is significantly higher than in the general population and may be associated with allergic polarization.
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Affiliation(s)
- Nicole Du
- Pediatric Residency Program, Children's National Hospital, Washington, District of Columbia, USA
- Division of Pediatric Gastroenterology, Children's National Hospital, Washington, District of Columbbia, USA
| | - Clarivet Torres
- Pediatric Residency Program, Children's National Hospital, Washington, District of Columbia, USA
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Abstract
Non-IgE-mediated food allergies are a group of disorders characterized by subacute or chronic inflammatory processes in the gut. Unlike IgE mediated food allergies that may result in multi-organ system anaphylaxis, the non-IgE mediated food allergies primarily affect the gastrointestinal tract. This review outlines the clinical manifestations, epidemiology, pathophysiology, and management of non-IgE-mediated food allergies. An updated literature search of selected non-IgE-mediated food allergies was conducted for this review using PubMed database to the current year (2021). Reviewed disorders include food protein-induced enterocolitis syndrome (FPIES), food-protein enteropathy (FPE), food protein-induced allergic proctocolitis (FPIAP), and eosinophilic gastrointestinal disorders (EGIDs) such as eosinophilic esophagitis (EoE). While extensive gains have been made in understanding FPIES, FPIAP, FPE, and EoE, more information is needed on the pathophysiology of these food allergies. Similarities among them include involvement of innate immunity, T-lymphocyte processes, alteration of the intestinal lumen at the cellular level with the appearance of inflammatory cells and associated histologic changes, and specific cytokine profiles suggesting food-specific, T-cell, and immune-mediated responses. While FPIES and FPIAP typically resolve in early childhood, EGIDs typically do not. Emerging new therapies for EoE offer promise of additional treatment options. Further studies identifying the immunopathogenesis, associated biomarkers, and mechanisms of tolerance are needed to inform prevention, diagnosis and management.
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Affiliation(s)
- Shouling Zhang
- Department of Pediatrics, Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, The Elliot and Roslyn Jaffe Food Allergy Institute, New York, NY, USA
| | - Scott Sicherer
- Department of Pediatrics, Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, The Elliot and Roslyn Jaffe Food Allergy Institute, New York, NY, USA
| | - M Cecilia Berin
- Department of Pediatrics, Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, The Elliot and Roslyn Jaffe Food Allergy Institute, New York, NY, USA
| | - Amanda Agyemang
- Department of Pediatrics, Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, The Elliot and Roslyn Jaffe Food Allergy Institute, New York, NY, USA
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Ataka R, Tanaka H, Yagi S, Yamane K, Yoshino K, Miyauchi T, Yoh T, Arafuka K, Fujita S, Hamada A, Endo B, Uemoto S. Eosinophilic peritonitis with colon cancer: a case report. BMC Gastroenterol 2020; 20:353. [PMID: 33109117 PMCID: PMC7590699 DOI: 10.1186/s12876-020-01500-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 10/14/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Eosinophilic gastrointestinal disorders (EGIDs) are a rare group of inflammatory disorders that can occur anywhere along the gastrointestinal tract, from the esophagus to the rectum. In particular, those with malignant or benign tumors are extremely rare. CASE PRESENTATION A 62-year-old man was referred to our hospital with a chief complaint of abdominal fullness. The peripheral white blood cell count was 19,400/µL, and the eosinophil count was 13,300/µL. Abdominal computed tomography showed massive ascites. Cytology of the ascitic fluid showed a large amount of eosinophils and no malignancy. Upper and lower gastrointestinal endoscopies were performed on the suspicion of EGIDs, and colon cancer with no other abnormalities was found. The biopsies of the cancer lesions and non-cancer lesions also showed significant differences in eosinophil counts per high-power field (HPF) between the cancer and non-cancer lesions (median 77.5 [IQR 52-115] vs. 40.5 [35-56]/HPF, P < 0.05). Exploratory laparoscopy showed cloudy massive ascites and thickening of the mesentery. Pathological examination of the mesentery showed a large amount of eosinophils (median 177.5 [IQR 91-227]/HPF) and no malignancy. Based on these findings, it was suspected that the massive ascites due to eosinophilic peritonitis could be associated with colon cancer. Steroid administration resulted in immediate disappearance of the ascites, and laparoscopic left hemicolectomy was safely performed 6 weeks after steroid administration. CONCLUSION This report presented a case of eosinophilic peritonitis that could be related to colon cancer. Exploratory laparoscopy was useful to detect the cause of ascites. The possibility that eosinophilic peritonitis was associated with colon cancer is discussed based on the histopathological findings.
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Affiliation(s)
- Ryo Ataka
- Department of General Surgery, Tango Central Hospital, 158-1 Sugitani, Mineyama-Cho, Tango, Kyoto, 627-8555, Japan.,Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hirokazu Tanaka
- Department of General Surgery, Tango Central Hospital, 158-1 Sugitani, Mineyama-Cho, Tango, Kyoto, 627-8555, Japan. .,Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Shintaro Yagi
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kei Yamane
- Department of General Surgery, Tango Central Hospital, 158-1 Sugitani, Mineyama-Cho, Tango, Kyoto, 627-8555, Japan.,Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenji Yoshino
- Department of General Surgery, Tango Central Hospital, 158-1 Sugitani, Mineyama-Cho, Tango, Kyoto, 627-8555, Japan.,Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoyuki Miyauchi
- Department of General Surgery, Tango Central Hospital, 158-1 Sugitani, Mineyama-Cho, Tango, Kyoto, 627-8555, Japan.,Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoaki Yoh
- Department of General Surgery, Tango Central Hospital, 158-1 Sugitani, Mineyama-Cho, Tango, Kyoto, 627-8555, Japan.,Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keiichi Arafuka
- Department of General Surgery, Tango Central Hospital, 158-1 Sugitani, Mineyama-Cho, Tango, Kyoto, 627-8555, Japan
| | - Shinichi Fujita
- Department of General Surgery, Tango Central Hospital, 158-1 Sugitani, Mineyama-Cho, Tango, Kyoto, 627-8555, Japan.,Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiko Hamada
- Department of Gastroenterology, Tango Central Hospital, Kyoto, Japan
| | - Bunji Endo
- Department of Gastroenterology, Tango Central Hospital, Kyoto, Japan
| | - Shinji Uemoto
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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