Small Intestine.

Abstract

Introduction: While recent studies have suggested that there might be an association between eosinophilic esophagitis (EoE) and celiac disease, there is a lack of studies on non-EoE eosinophilic gastrointestinal diseases (EGIDs) and celiac disease. We sought to determine the relationship between eosinophilic gastroenteritis (EoGE) and eosinophilic colitis (EoC), and celiac disease and describe the epidemiology of individuals with EoGE and EoC with co-existent celiac disease in the United States (US), utilizing a large population-based database. Methods: We queried a commercial database (Explorys Inc, Cleveland, OH), an aggregate of electronic health record data from 26 major integrated US healthcare systems from 1999 to May 2017. We identified an aggregated patient cohort of eligible patients with EoGE, EoC and concomitant celiac disease between May 2012 and May 2017, based on Systematized Nomenclature Of Medicine - Clinical Terms (SNOMED-CT). We calculated the prevalence of celiac disease in EoGE and EoC, among different patient groups. Results: Of the 35,795,250 individuals in the database active between May 2012 and May 2017, we identified 1,440 and 800 patients with EoGE and EoC respectively, and 84,040 patients with celiac disease. The overall 5-year prevalence rates of EoGE, EoC and celiac disease were 4/100,000, 2.2/100,000 and 234.8/100,000 persons respectively. 50 patients with EoGE also had concomitant celiac disease with the overall prevalence of celiac disease in EoGE being 3.5% (Figure 1) with an odds ratio (OR) of 15.37 (95% CI: 11.60-20.39, p < 0.0001) compared to individuals without eosinophilic gastrointestinal diseases. 30 patients with EoC also had concomitant celiac disease with the overall prevalence of celiac disease in EoC being 3.7% (OR 16.03; 95% CI: 11.13-23.08, p < 0.0001). The prevalence of celiac disease was higher in females vs males in EoGE (OR 1.11; 95% CI: 0.62-1.97, p=0.7310). Celiac disease presented predominantly in the Caucasian population in both EoGE (80%) and EoC (100%).Figure: Prevalence (%) of celiac disease in Eosinophilic Gastroenteritis (EoGE) and Eosinophilic Colitis (EoC).Conclusion: In this large population-based study, we found that the estimated 2012-2017 prevalence rates of celiac disease in EoGE and EoC are 3.5% and 3.7% respectively. This is one of the first large epidemiology studies that has demonstrated a significant association between celiac disease and non-EoE EGIDs. Further studies are needed to understand the mechanism of association between these disorders.