Recurrent blood eosinophilia in ulcerative colitis is associated with severe disease and primary sclerosing cholangitis

Arthur Barrie, Marwa El Mourabet, Katherine Weyant, Kofi Clarke, Mahesh Gajendran, Claudia Rivers, Seo Young Park, Douglas Hartman, Melissa Saul, Miguel Regueiro, Dhiraj Yadav, David G. Binion

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background and Aims: Eosinophils are implicated in the pathogenesis of inflammatory bowel disease (IBD). A subset of IBD patients develops blood eosinophilia, and the clinical profile of these patients is undefined. We sought to characterize IBD patients with and without eosinophilia. Methods: We studied a prospective registry of 1,176 IBD patients followed in a tertiary referral center. Patients who developed eosinophilia at any time were identified by electronic medical record query. We performed a chart review case-control study comparing patients with recurrent eosinophilia versus randomly selected disease-matched patients with no history of eosinophilia. Histological analysis was performed on selected cases and controls. Results: Eosinophilia at any time was more prevalent in ulcerative colitis (UC) patients than Crohn's disease patients (22.2 versus 12.7 %), as was recurrent eosinophilia (3.4 versus 0.7 %). UC patients with recurrent eosinophilia were predominantly male compared with the control UC population (81.3 versus 46.9 %) and had higher rates of colectomy for either medically refractory disease or dysplasia/cancer than control UC patients (56.3 versus 15.6 %). Primary sclerosing cholangitis (PSC) occurred in 37.5 % of UC patients with recurrent eosinophilia compared with only 3.1 % in the UC controls. Histological analysis of random diagnostic samples from UC patients with recurrent eosinophilia demonstrated a normal eosinophil pattern as seen in the control UC population. Conclusions: Eosinophilia-associated UC is a subgroup of IBD associated with severe colitis and PSC. Further studies are warranted to characterize molecular mechanisms underlying eosinophilia- associated UC and to determine optimal approaches for therapy.

Original languageEnglish (US)
Pages (from-to)222-228
Number of pages7
JournalDigestive Diseases and Sciences
Volume58
Issue number1
DOIs
StatePublished - Jan 1 2013

Fingerprint

Sclerosing Cholangitis
Eosinophilia
Ulcerative Colitis
Inflammatory Bowel Diseases
Eosinophils
Crohn Disease
Colectomy
Electronic Health Records
Colitis
Tertiary Care Centers
Population
Registries
Case-Control Studies

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

Cite this

Barrie, Arthur ; Mourabet, Marwa El ; Weyant, Katherine ; Clarke, Kofi ; Gajendran, Mahesh ; Rivers, Claudia ; Park, Seo Young ; Hartman, Douglas ; Saul, Melissa ; Regueiro, Miguel ; Yadav, Dhiraj ; Binion, David G. / Recurrent blood eosinophilia in ulcerative colitis is associated with severe disease and primary sclerosing cholangitis. In: Digestive Diseases and Sciences. 2013 ; Vol. 58, No. 1. pp. 222-228.
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title = "Recurrent blood eosinophilia in ulcerative colitis is associated with severe disease and primary sclerosing cholangitis",
abstract = "Background and Aims: Eosinophils are implicated in the pathogenesis of inflammatory bowel disease (IBD). A subset of IBD patients develops blood eosinophilia, and the clinical profile of these patients is undefined. We sought to characterize IBD patients with and without eosinophilia. Methods: We studied a prospective registry of 1,176 IBD patients followed in a tertiary referral center. Patients who developed eosinophilia at any time were identified by electronic medical record query. We performed a chart review case-control study comparing patients with recurrent eosinophilia versus randomly selected disease-matched patients with no history of eosinophilia. Histological analysis was performed on selected cases and controls. Results: Eosinophilia at any time was more prevalent in ulcerative colitis (UC) patients than Crohn's disease patients (22.2 versus 12.7 {\%}), as was recurrent eosinophilia (3.4 versus 0.7 {\%}). UC patients with recurrent eosinophilia were predominantly male compared with the control UC population (81.3 versus 46.9 {\%}) and had higher rates of colectomy for either medically refractory disease or dysplasia/cancer than control UC patients (56.3 versus 15.6 {\%}). Primary sclerosing cholangitis (PSC) occurred in 37.5 {\%} of UC patients with recurrent eosinophilia compared with only 3.1 {\%} in the UC controls. Histological analysis of random diagnostic samples from UC patients with recurrent eosinophilia demonstrated a normal eosinophil pattern as seen in the control UC population. Conclusions: Eosinophilia-associated UC is a subgroup of IBD associated with severe colitis and PSC. Further studies are warranted to characterize molecular mechanisms underlying eosinophilia- associated UC and to determine optimal approaches for therapy.",
author = "Arthur Barrie and Mourabet, {Marwa El} and Katherine Weyant and Kofi Clarke and Mahesh Gajendran and Claudia Rivers and Park, {Seo Young} and Douglas Hartman and Melissa Saul and Miguel Regueiro and Dhiraj Yadav and Binion, {David G.}",
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Barrie, A, Mourabet, ME, Weyant, K, Clarke, K, Gajendran, M, Rivers, C, Park, SY, Hartman, D, Saul, M, Regueiro, M, Yadav, D & Binion, DG 2013, 'Recurrent blood eosinophilia in ulcerative colitis is associated with severe disease and primary sclerosing cholangitis', Digestive Diseases and Sciences, vol. 58, no. 1, pp. 222-228. https://doi.org/10.1007/s10620-012-2329-7

Recurrent blood eosinophilia in ulcerative colitis is associated with severe disease and primary sclerosing cholangitis. / Barrie, Arthur; Mourabet, Marwa El; Weyant, Katherine; Clarke, Kofi; Gajendran, Mahesh; Rivers, Claudia; Park, Seo Young; Hartman, Douglas; Saul, Melissa; Regueiro, Miguel; Yadav, Dhiraj; Binion, David G.

In: Digestive Diseases and Sciences, Vol. 58, No. 1, 01.01.2013, p. 222-228.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Recurrent blood eosinophilia in ulcerative colitis is associated with severe disease and primary sclerosing cholangitis

AU - Barrie, Arthur

AU - Mourabet, Marwa El

AU - Weyant, Katherine

AU - Clarke, Kofi

AU - Gajendran, Mahesh

AU - Rivers, Claudia

AU - Park, Seo Young

AU - Hartman, Douglas

AU - Saul, Melissa

AU - Regueiro, Miguel

AU - Yadav, Dhiraj

AU - Binion, David G.

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Background and Aims: Eosinophils are implicated in the pathogenesis of inflammatory bowel disease (IBD). A subset of IBD patients develops blood eosinophilia, and the clinical profile of these patients is undefined. We sought to characterize IBD patients with and without eosinophilia. Methods: We studied a prospective registry of 1,176 IBD patients followed in a tertiary referral center. Patients who developed eosinophilia at any time were identified by electronic medical record query. We performed a chart review case-control study comparing patients with recurrent eosinophilia versus randomly selected disease-matched patients with no history of eosinophilia. Histological analysis was performed on selected cases and controls. Results: Eosinophilia at any time was more prevalent in ulcerative colitis (UC) patients than Crohn's disease patients (22.2 versus 12.7 %), as was recurrent eosinophilia (3.4 versus 0.7 %). UC patients with recurrent eosinophilia were predominantly male compared with the control UC population (81.3 versus 46.9 %) and had higher rates of colectomy for either medically refractory disease or dysplasia/cancer than control UC patients (56.3 versus 15.6 %). Primary sclerosing cholangitis (PSC) occurred in 37.5 % of UC patients with recurrent eosinophilia compared with only 3.1 % in the UC controls. Histological analysis of random diagnostic samples from UC patients with recurrent eosinophilia demonstrated a normal eosinophil pattern as seen in the control UC population. Conclusions: Eosinophilia-associated UC is a subgroup of IBD associated with severe colitis and PSC. Further studies are warranted to characterize molecular mechanisms underlying eosinophilia- associated UC and to determine optimal approaches for therapy.

AB - Background and Aims: Eosinophils are implicated in the pathogenesis of inflammatory bowel disease (IBD). A subset of IBD patients develops blood eosinophilia, and the clinical profile of these patients is undefined. We sought to characterize IBD patients with and without eosinophilia. Methods: We studied a prospective registry of 1,176 IBD patients followed in a tertiary referral center. Patients who developed eosinophilia at any time were identified by electronic medical record query. We performed a chart review case-control study comparing patients with recurrent eosinophilia versus randomly selected disease-matched patients with no history of eosinophilia. Histological analysis was performed on selected cases and controls. Results: Eosinophilia at any time was more prevalent in ulcerative colitis (UC) patients than Crohn's disease patients (22.2 versus 12.7 %), as was recurrent eosinophilia (3.4 versus 0.7 %). UC patients with recurrent eosinophilia were predominantly male compared with the control UC population (81.3 versus 46.9 %) and had higher rates of colectomy for either medically refractory disease or dysplasia/cancer than control UC patients (56.3 versus 15.6 %). Primary sclerosing cholangitis (PSC) occurred in 37.5 % of UC patients with recurrent eosinophilia compared with only 3.1 % in the UC controls. Histological analysis of random diagnostic samples from UC patients with recurrent eosinophilia demonstrated a normal eosinophil pattern as seen in the control UC population. Conclusions: Eosinophilia-associated UC is a subgroup of IBD associated with severe colitis and PSC. Further studies are warranted to characterize molecular mechanisms underlying eosinophilia- associated UC and to determine optimal approaches for therapy.

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SN - 0163-2116

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