Abstract：Objective To study the predictive factors for glucocorticoid therapy by analyzing the association between the clinical features and treatment regimens in children with eosinophilic gastroenteritis. Methods A retrospective analysis was performed on the medical data of 182 children with eosinophilic gastroenteritis who were admitted to Guangzhou Women and Children's Medical Center from January 2012 to December 2020. According to whether glucocorticoids were used, these children were divided into a glucocorticoid treatment group and a control group. The two groups were compared in terms of age, history of allergy, clinical symptoms, laboratory examination results, endoscopic findings, and pathological results of gastrointestinal mucosa. A multivariate logistic regression analysis was performed for the results with statistical significance. Results Of the 182 children, 36 (19.8%) received glucocorticoid therapy. The rates of hematochezia, anemia, and mucosal ulceration/luminal stenosis under endoscopy and the mucosal eosinophil infiltration count were significantly higher in the glucocorticoid treatment group than those in the control group (P<0.05). The serum albumin level in the glucocorticoid treatment group was significantly lower than that in the control group (P<0.05). The multivariate logistic regression analysis showed that mucosal ulceration/luminal stenosis under endoscopy (OR=10.830, 95%CI: 3.090-37.961, P<0.001) and the increased mucosal eosinophil infiltration count (OR=0.967, 95%CI: 0.941-0.993, P=0.015) were predictive factors for glucocorticoid therapy in children with eosinophil gastroenteritis. Conclusions Mucosal ulceration/luminal stenosis under endoscopy or a significant increase in the mucosal eosinophil infiltration count based on pathology suggests that glucocorticoid therapy can be considered in children with eosinophil gastroenteritis. Citation:
REN Lu,LI Hui-Wen,XIONG Li-Ya et al. Predictive factors for glucocorticoid therapy in children with eosinophilic gastroenteritis[J]. CJCP, 2021, 23(11): 1149-1153.
Talley NJ, Shorter RG, Phillips SF, et al. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues[J]. Gut, 1990, 31(1): 54-58. PMID: 2318432. PMCID: PMC1378340. DOI: 10.1136/gut.31.1.54.
Doi M, Furuichi Y, Tsuji S, et al. Eosinophilic gastroenteritis treated with a targeted food elimination diet[J]. Pediatr Int, 2020, 62(7): 866-868. PMID: 32705784. DOI: 10.1111/ped.14217.
Tien FM, Wu JF, Jeng YM, et al. Clinical features and treatment responses of children with eosinophilic gastroenteritis[J]. Pediatr Neonatol, 2011, 52(5): 272-278. PMID: 22036223. DOI: 10.1016/j.pedneo.2011.06.006.
Yang M, Geng LL, Chen PY, et al. Effectiveness of dietary allergen exclusion therapy on eosinophilic colitis in Chinese infants and young children ≤ 3 years of age[J]. Nutrients, 2015, 7(3): 1817-1827. PMID: 25768952. PMCID: PMC4377883. DOI: 10.3390/nu7031817.
Matsushita T, Maruyama R, Ishikawa N, et al. The number and distribution of eosinophils in the adult human gastrointestinal tract: a study and comparison of racial and environmental factors[J]. Am J Surg Pathol, 2015, 39(4): 521-527. PMID: 25581733. DOI: 10.1097/PAS.0000000000000370.
Pineton de Chambrun G, Gonzalez F, Canva JY, et al. Natural history of eosinophilic gastroenteritis[J]. Clin Gastroenterol Hepatol, 2011, 9(11): 950-956.e1. PMID: 21806952. DOI: 10.1016/j.cgh.2011.07.017.
Rawla P, Sunkara T, Thandra KC, et al. Efficacy and safety of budesonide in the treatment of eosinophilic esophagitis: updated systematic review and meta-analysis of randomized and non-randomized studies[J]. Drugs R D, 2018, 18(4): 259-269. PMID: 30387081. PMCID: PMC6277325. DOI: 10.1007/s40268-018-0253-9.
Kennedy K, Muir AB, Grossman A, et al. Modified oral enteric-coated budesonide regimens to treat pediatric eosinophilic gastroenteritis, a single center experience[J]. J Allergy Clin Immunol Pract, 2019, 7(6): 2059-2061. PMID: 30763733. PMCID: PMC7064262. DOI: 10.1016/j.jaip.2019.01.053.
