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    Clinical Implications of Pediatric Colonic Eosinophilia


    Mark, Jacob and Fernando, Shahan D. and Masterson, Joanne C. and Pan, Zhaoxing and Capocelli, Kelley E. and Furuta, Glenn T. and de Zoeten, Edwin F. (2018) Clinical Implications of Pediatric Colonic Eosinophilia. Journal of Pediatric Gastroenterology and Nutrition, 66 (5). pp. 760-766. ISSN 1536-4801

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    Abstract

    Objective: Pediatric colonic eosinophilia represents a confounding finding with a wide differential. It is often difficult to determine which children may progress to inflammatory bowel disease (IBD), which have an eosinophilic colitis (EC), and which may have no underlying pathology. There is little guidance for the practitioner on the approach to these patients. To define the clinical presentations of colonic eosinophilia and identify factors which may aid in diagnosis we reviewed patients with colonic eosinophilia and the clinicopathologic factors associated with their diagnoses. Mehtods: An 8-year retrospective chart review of children whose histopathology identified colonic eosinophilia (N = 72) compared to controls with normal biopsies (N = 35). Results: Patients with colonic eosinophilia had increased eosinophils/high-power field compared to controls (P < 0.001) and had 3 clinical phenotypes. Thirty-six percent had an inflammatory phenotype with elevated erythrocyte sedimentation rate (P < .0001), chronic inflammation on colonic biopsies (P < 0.001), and were diagnosed as having IBD. Thirty-seven percent were diagnosed as having EC, associated with male sex (P < 0.005) and peripheral eosinophilia (P = 0.041). Twenty-one percent had no significant colonic pathology. Forty-three percent of patients had >1 colonoscopy and 68% of these had change from initial diagnoses. Conclusions: There are 3 main phenotypes of children with colonic eosinophilia. Signs of chronic systemic inflammation raise suspicion for IBD. Peripheral eosinophilia and male sex are associated with EC. A significant percent of children with colonic eosinophilia do not have colonic disease. Eosinophils/high-power field is not reliable to differentiate etiologies. Repeat colonoscopies may be required to reach final diagnoses.

    Item Type: Article
    Keywords: Eosinophilic Colitis; Inflammatory Bowel Disease; Eosinophil;
    Academic Unit: Faculty of Science and Engineering > Biology
    Faculty of Science and Engineering > Research Institutes > Human Health Institute
    Item ID: 11665
    Identification Number: https://doi.org/10.1097/MPG.000000000000178
    Depositing User: Joanne Masterson
    Date Deposited: 06 Nov 2019 17:02
    Journal or Publication Title: Journal of Pediatric Gastroenterology and Nutrition
    Publisher: Lippincott, Williams & Wilkins
    Refereed: Yes
    URI:

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