High Prevalence of Eosinophilic Gastrointestinal Disease in Children With Intestinal Failure

J Pediatr Gastroenterol Nutr. 2016 Sep;63(3):336-9. doi: 10.1097/MPG.0000000000001158.


Objectives: The aim of the present study was to describe the prevalence and clinical features of gastrointestinal (GI) eosinophilic inflammation among pediatric patients with intestinal failure (IF).

Methods: Medical records of all patients studied in our institution's IF program who underwent GI endoscopy over a 15-year period were reviewed, and clinical, pathologic, nutrition, and laboratory data collected.

Results: One hundred five patients underwent 208 GI endoscopic procedures with biopsy. The overall prevalence of eosinophilic inflammation, defined as increased eosinophils in at least 1 tissue type on at least 1 endoscopy, was 39 of 105 (37%). The tissue-specific prevalence of eosinophilic inflammation ranged widely, with the colon/rectosigmoid being the most common (18/68, 26%), followed by the esophagus (17/83, 20%), ileum (9/54, 17%), duodenum (4/83, 5%), and stomach (3/83, 4%). Higher peripheral eosinophil count and hematochezia were associated with eosinophilic inflammation in the colon (P = 0.002 and 0.0004, respectively). The use of a strict elemental diet for 3 months before endoscopy was not associated with a decreased frequency of eosinophilic inflammation in any tissue.

Conclusions: Eosinophilic inflammation is a common histopathological finding in patients with IF. Colonic eosinophilic inflammation is associated with clinical symptoms of GI blood loss, and peripheral eosinophilia, and was not abrogated by a strict elemental diet.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Child, Preschool
  • Endoscopy
  • Enteritis / complications
  • Enteritis / diagnosis
  • Enteritis / diet therapy
  • Enteritis / epidemiology*
  • Eosinophilia / complications
  • Eosinophilia / diagnosis
  • Eosinophilia / diet therapy
  • Eosinophilia / epidemiology*
  • Female
  • Gastritis / complications
  • Gastritis / diagnosis
  • Gastritis / diet therapy
  • Gastritis / epidemiology*
  • Humans
  • Infant
  • Male
  • Parenteral Nutrition / adverse effects
  • Prevalence
  • Retrospective Studies
  • Risk Factors

Supplementary concepts

  • Eosinophilic enteropathy