caa a22 4500 445797894 CHVBK 20180317145131.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s10620-011-1754-3 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1754-3 Eosinophilic Gastrointestinal Disorders (EGID) with Peripheral Eosinophilia: A Retrospective Review at Mayo Clinic [Elektronische Daten] [Joohee Lee, Ross Dierkhising, Tsung-Teh Wu, Jeffrey Alexander, Catherine Weiler] Background and Aims: Hypereosinophilic syndrome (HES) is defined by significant eosinophilia (>1,500eos/μl), which often leads to end-organ damage/dysfunction. It is unclear if the presence of significant peripheral eosinophilia (>1,500eos/μl) indicates a more aggressive form of eosinophilic gastrointestinal disorder (EGID). Methods: A database query of the Mayo Clinic Rochester electronic records (1995-2008) was performed using several search terms for eosinophilic gastrointestinal disease, and 161 records were reviewed. Patients under 18years age, those without Mayo-reviewed pathology specimens, those with eosinophilic esophagitis only, and/or those with evidence of secondary etiologies for GI eosinophilia were excluded. A total of 39 were found to have primary EGID. We compared individuals with biopsy-proven primary EGID based on whether they had significant peripheral eosinophilia (≥1,500eos/μl) (group A) or not (group B). Results: Group A tended to have more atopy (A: 12/15; B: 11/24; p=0.03) and more extensive segmental involvement of the GI tract (p=0.001). None with available studies had evidence of cardiac (A: 7/15; B: 6/24) or bone marrow (A: 10/15; B: 6/24) involvement. The two thromboembolic events in group A after diagnosis did not translate to significantly greater risk (HR=infinity, p=0.13; group A vs. B). Doses of initial (A: 40mg/day; B: 55mg/day; p=0.17) and maintenance prednisone (A; 8.75mg/day; B: 7.5mg/day; p>0.90) were similar. Group A was significantly more likely to need maintenance prednisone (77 vs. 8%, p=0.001), with a median treatment duration of 52weeks. Recurrence of symptoms (and peripheral eosinophilia) during prednisone taper was common in both groups. Prednisone-sparing agents (hydroxyurea, imatinib mesylate, interferon (IFN)-α2b, anti-interleukin (IL-5) monoclonal antibody) were more commonly used in group A (73 vs. 8%; p<0.0001). Conclusions: EGID with peripheral eosinophilia ≥1,500/μl is associated with atopy, greater GI segmental involvement, and uncertain risk of thrombosis. The common use of long-term steroids and variable responsiveness to nonsteroidal agents, particularly in group A, underscores the need for targeted therapies. Springer Science+Business Media, LLC, 2011 Eosinophilic gastrointestinal disorders nationallicence Eosinophilic gastroenteritis nationallicence Eosinophilia nationallicence EC : Eosinophilic colitis nationallicence EEn : Eosinophilic enteritis nationallicence EG : Eosinophilic gastritis nationallicence EGE : Eosinophilic gastroenteritis nationallicence EGID : Eosinophilic gastrointestinal disorders nationallicence EoE : Eosinophilic esophagitis nationallicence HES : Hypereosinophilic syndrome nationallicence IFN : Interferon nationallicence Lee Joohee Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA aut Dierkhising Ross Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA aut Wu Tsung-Teh Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA aut Alexander Jeffrey Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA aut Weiler Catherine Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3254-3261 0163-2116 56:11<3254 2011 56 10620 https://doi.org/10.1007/s10620-011-1754-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1754-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lee Joohee Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Dierkhising Ross Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Wu Tsung-Teh Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Alexander Jeffrey Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Weiler Catherine Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3254-3261 0163-2116 56:11<3254 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer