Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2024; 30(2): 146-157
Published online Jan 14, 2024. doi: 10.3748/wjg.v30.i2.146
Long-term prognosis and its associated predictive factors in patients with eosinophilic gastroenteritis
Kai-Wen Li, Ge-Chong Ruan, Shuang Liu, Tian-Ming Xu, Ye Ma, Wei-Xun Zhou, Wei Liu, Peng-Yu Zhao, Zhi-Rong Du, Ji Li, Jing-Nan Li
Kai-Wen Li, Ge-Chong Ruan, Tian-Ming Xu, Ye Ma, Ji Li, Jing-Nan Li, Department of Gastroenterology, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
Shuang Liu, Zhi-Rong Du, Department of Allergy, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
Wei-Xun Zhou, Department of Pathology, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
Wei Liu, Department of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
Peng-Yu Zhao, Affairs Office, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital (West campus), Beijing 100032, China
Co-first authors: Kai-Wen Li and Ge-Chong Ruan.
Co-corresponding authors: Ji Li and Jing-Nan Li.
Author contributions: Li KW, Ruan GC, Li J and Li JN designed the study; Li KW, Ruan GC, Zhou WX and Liu W acquired and analyzed the data; Liu S, Xu TM, Ma Y and Du ZR helped with patient follow-up; Zhao PY contributed to the statistical methodology; Li J and Li JN provided resources and acquired funding; Li KW, Ruan GC, Li J and Li JN wrote the paper. During the course of this study, Li KW and Ruan GC made equal contributions across various stage. Their involvement encompassed the design of the study, selection of patients, collection of baseline data, follow-up via telephone calls and outpatient services, as well as data analysis and the drafting of the article, thus leading to shared first authorship. Furthermore, the study also benefited from the substantial contributions of Li J and Li JN. They played equally vital roles in the process of study design, funding support, article writing and reviewing, thereby sharing co-correspondence authorship. These collaborative efforts have been instrumental in shaping the final outcome of this work.
Supported by National High Level Hospital Clinical Research Funding, No. 2022-PUMCH-B-022; CAMS Innovation Fund for Medical Sciences, No. CIFMS 2021-1-I2M-003; and Undergraduate Innovation Program, No. 2023zglc06076.
Institutional review board statement: The study was reviewed and approved by the Chinese Academy of Medical Sciences and Peking Union Medical College Hospital Institutional Review Board (Approval No. I-23PJ1227).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ji Li, MD, Doctor, Department of Gastroenterology, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing, Beijing 100730, China. liji0235@pumch.cn
Received: August 22, 2023
Peer-review started: August 22, 2023
First decision: November 20, 2023
Revised: November 28, 2023
Accepted: December 25, 2023
Article in press: December 25, 2023
Published online: January 14, 2024
ARTICLE HIGHLIGHTS
Research background

Eosinophilic gastroenteritis (EGE) is a rare, chronic and recurrent disease with abnormal eosinophilic infiltration in gastrointestinal tract. Disease relapse and glucocorticoid dependence remain notable problems.

Research motivation

Few studies had illuminated the prognosis of EGE and risk factors for disease relapse. By exploring prognostic factors by baseline clinical data, we may identify patients who are more vulnerable for disease relapse at diagnosis and offer them individualized treatment.

Research objectives

To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.

Research methods

This retrospective cohort study enrolled 55 EGE patients (2013-2022, Peking Union Medical College Hospital) and analyzed their clinical records. Kaplan-Meier analysis, Log-Rank test and Cox regression analysis were conducted to reveal the risk factors for long-term prognosis.

Research results

In our cohort, EGE showed a female predominance (56.4%) and its median onset age was 38 years old. Abdominal pain (89.1%) was most commonly seen. 78.2% of patients received glucocorticoid treatment in whom elevated serum immunoglobin E (IgE) at diagnosis (86.8% vs 50.0%, P = 0.022) and descending duodenum involvement (62.8% vs 27.3%, P = 0.046) were more frequently seen. The median follow-up time was 67 mo, during which 31 patients (56.4%) suffered from at least one flares of disease relapse. Six prognostic factors were figured out, including age at diagnosis < 40 years (hazard ratio (HR) 2.0408, 95% confidence interval (CI): 1.0082-4.1312, P = 0.044), body mass index > 24 kg/m2 (HR 0.3922, 95%CI: 0.1916-0.8027, P = 0.014), disease duration from symptom onset to diagnosis > 3.5 mo (HR 2.4725, 95%CI: 1.220-5.0110, P = 0.011), vomiting (HR 3.1259, 95%CI: 1.5246-6.4093, P = 0.001), total serum IgE > 300 KU/L at diagnosis (HR 0.2773, 95%CI: 0.1204-0.6384, P = 0.022) and glucocorticoid treatment (HR 6.1434, 95%CI: 2.8446-13.2676, P = 0.003).

Research conclusions

We identified younger onset age, longer disease course, vomiting and glucocorticoid treatment to be risk factors for disease relapse, whereas higher body mass index and total-IgE level at baseline to be protective.

Research perspectives

In future research, we tend to conduct multi-center prospective study to verify and improve our prognostic model and further explore more accurate biomarkers for disease relapse based on serum proteomics and intestinal microbiomes.