Implications of eosinophilia in the normal duodenal biopsy - an association with allergy and functional dyspepsia.
Aliment Pharmacol Ther. 2010 Mar 4;
Authors: Walker MM, Salehian SS, Murray CE, Rajendran A, Hoare JM, Negus R, Powell N, Talley NJ
SUMMARY Background: Allergy and functional gastrointestinal disorders have been associated with eosinophilia in duodenal mucosa. Aim: To assess the prevalence of eosinophilia in duodenal biopsies of patients attending for oesophogastroduodenoscopy and delineate associated clinical conditions. Methods: 155 patients (mean age 55 years, 59% females) with normal duodenal biopsies were randomly selected for audit from histopathology files. Eosinophil counts in 5 high power fields (HPFs) were assessed. Records were analysed for symptoms, diagnosis and medications; patients divided into 5 groups based on upper gastrointestinal (UGI) symptom profiles, including a control group of those without predominant UGI symptoms. The prevalence of duodenal eosinophilia (defined as >22/5HPFs a priori) was calculated. Results: In the control group the mean duodenal eosinophil count was 15/5HPFs; prevalence of duodenal eosinophilia 22.5%. In postprandial distress syndrome (PDS) both mean eosinophil counts (20.2/5HPF, p<0.04) and prevalence of duodenal eosinophilia (47.3%, p<0.04) were significantly higher. Duodenal eosinophilia was significantly associated with allergy (OR 5.04, 95% CI 2.12-11.95, p<0.001). There was no association with irritable bowel syndrome or medications. Conclusions: Subtle duodenal eosinophilia is relatively common in routine oesophogastroduodenoscopy and previously overlooked; it is associated with allergy and may indicate a hypersensitivity mechanism in some patients with PDS including early satiety.
PMID: 20222916 [PubMed - as supplied by publisher]
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