Eosinophilic gastrointestinal disorders (EGIDs) are a heterogeneous group of emerging chronic inflammatory diseases that may affect different gastrointestinal (GI) tracts. Based on the anatomical site involved, EGIDs are distinguished into eosinophilic esophagitis (EoE) and non-esophageal forms, which are subdivided into eosinophilic gastritis (EoG), gastroenteritis (EoGE), and colitis (EoC). EoE is considered the prototype of EGIDs. Since the first description of a case series of patients with EoE, fundamental scientific advances have been achieved, culminating in the redaction of international diagnostic and therapeutic guidelines. In contrast to EoE, non-esophageal forms of EGIDs are still a clinical enigma with evidence limited to a few retrospective studies. In the last decade, an increase in the prevalence of EGIDs has been observed in the pediatric age. Unfortunately, the epidemiology of EGIDs in Italy is still inconsistent and clear estimates are not available.
Firstly, this study will allow us to assess and clarify several clinical and epidemiological aspects of pediatric EGIDs, in particular:
1. prevalence and incidence of pediatric EGIDs in Italy, 2. the clinical features and potential phenotypes of pediatric EGIDs with potential impact on therapy and management, 3. diagnostic work-up and adherence to the EoE international guidelines to improve the management, quality of care, and quality of life of affected patients.
This study has no ethical problems since EoE patients are treated according to international guidelines and those with non-esophageal EGIDs according to the latest scientific evidence.
None
a diagnosis of EGIDs made more than five years before the study participation;
a diagnosis of EoE not in line with current international guidelines;
a secondary cause of intestinal eosinophilic inflammation (inflammatory bowel diseases, autoimmune diseases, vasculitis, graft versus host disease, malignancies).
EoE and EGIDs Definition: Based on current international guidelines, EoE diagnosis requires the presence of more than 15 eos/HPF in endoscopically obtained esophageal biopsies.5 In contrast, the diagnosis of non-esophageal EGIDs should meet the following criteria: * Chronic/recurrent GI symptoms unresponsive to standard therapies, * A prevalent eosinophilic intestinal inflammation, * Exclusion of secondary causes of intestinal eosinophilia (e.g., intestinal parasitosis, chronic inflammatory bowel disease, vasculitis, autoimmune diseases, graft versus host disease, tumors).
Cohort
Other
Not listed
Prevalence estimates
a) To estimate the EGIDs prevalence in patients with gastrointestinal symptoms undergoing upper and lower GI endoscopy, to verify whether the global increase of EGIDs also affects the Italian reality
Incidence estimates
b) If available the cumulative incidence (new EGIDs cases) may be derived, as a subgroup analysis of the primary endpoint
Prospective epidemiological estimates
a) To estimate the cumulative incidence of EGIDs (new diagnosis of EGIDs) over the study period.
Other epidemiological estimates
a) To compare the cumulative incidence of EGIDs observed in the prospective with the data from the retrospective study (if available) and those available in the literature, to verify the increase of EGIDs, previously observed in a few US observational studies;
Definition of clinical features and potential phenotypes
b) To describe the clinical characteristics of Italian patients with EGIDs (risk factors, sex, age, comorbidities, response to therapy, natural history), to identify potential phenotypes;
Improvement of diagnostic and therapeutic management
c) To define shared diagnostic-therapeutic management and verify the adherence of enrolled centers to the international EoE guidelines.
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Fondazione IRCCS Policlinico San Matteo di Pavia
Lead sponsor
Italian Society of Pediatric Allergy & Immunology - Pediatric Centers
Collaborator
