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Review
. 2023 Sep 20;13(9):1417.
doi: 10.3390/biom13091417.

Review of Non-Eosinophilic Esophagitis-Eosinophilic Gastrointestinal Disease (Non-EoE-EGID) and a Case Series of Twenty-Eight Affected Patients

Yoshikazu Kinoshita  1 , Tsuyoshi Sanuki  1
Affiliations
Review

Review of Non-Eosinophilic Esophagitis-Eosinophilic Gastrointestinal Disease (Non-EoE-EGID) and a Case Series of Twenty-Eight Affected Patients

Yoshikazu Kinoshita et al. Biomolecules. .

Abstract

Eosinophilic gastrointestinal disease (EGID) is divided into eosinophilic esophagitis (EoE) and non-eosinophilic esophagitis eosinophilic gastrointestinal disease (non-EoE-EGID) based on the involved gastrointestinal segments. Reports regarding non-EoE-EGID are limited, in part because of its rarity. The present study was performed to review non-EoE-EGID, including its pathogenesis, diagnosis, treatment, and prognosis. Additionally, details regarding 28 cases of non-EoE-EGID recently diagnosed at our Japanese tertial medical center are presented and compared with 20 EoE cases diagnosed during the same period at the same medical center. Comparisons of the two groups clarified differences regarding age- and gender-dependent prevalence between the two conditions, and also showed that systemic involvement and disease severity were greater in the non-EoE-EGID patients. Notably, diagnosis of non-EoE-EGID is difficult because of its lack of specific or characteristic symptoms and endoscopic findings. The clinical characteristics of EoE and non-EoE-EGID differ in many ways, while they also share several genetic, clinical, laboratory, and histopathological features.

Keywords: allergy; eosinophil; esophagus; functional dyspepsia; gastrointestinal tract; irritable bowel syndrome.

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Conflict of interest statement

The authors have no COIs concerning this manuscript.

Figures

Figure 1
Figure 1
Suggested pathogenesis of EoE.
Figure 2
Figure 2
Suggested pathogenesis of non-EoE-EGID. As compared with EoE, knowledge regarding the pathogenesis of non-EoE-EGID cases is limited.
Figure 3
Figure 3
Case series of 28 non-EoE-EGID and 20 EoE patients. Age and gender distribution for: (a) EoE and (b) non-EoE-EGID. Patients with EoE were mainly in their 40s and 50s, with a male preponderance. Patients with non-EoE-EGID had a wider age range with a female preponderance.
Figure 4
Figure 4
Case series of 28 non-EoE-EGID and 20 EoE patients: (a) Peripheral blood leucocyte count; (b) eosinophil fraction in leucocytes; (c) absolute eosinophil count. Elevated numbers of leucocytes and eosinophils were more frequently found in the non-EoE-EGID cases, with 68% of the non-EoE-EGID cases showing an elevated peripheral eosinophil count as compared to only 10% of the EoE cases; (d) peripheral blood hemoglobin concentration; (e) serum albumin; (f) LDH in EoE and non-EoE-EGID patients. Some of the non-EoE-EGID cases showed decreased hemoglobin and albumin concentrations, and increased LDH level, while, with respect to these measurements, there were no abnormal values among the EoE cases.
Figure 5
Figure 5
Case series of 28 non-EoE-EGID patients. Gastrointestinal tract involvement with eosinophilic inflammation was noted in patients with non-EoE-EGID. When more than two lesions were found in a single patient, each of the involved gastrointestinal segments was counted. The duodenum was the most frequently involved segment in non-EoE-EGID cases.
Figure 6
Figure 6
Peak numbers of eosinophils infiltrating different segments of the gastrointestinal tract in patients with non-EoE-EGID are shown.
See this image and copyright information in PMC

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