Su1856 No Increased Risk of Celiac Disease in Subjects With Esophageal Eosinophilia or Eosinophilic Esophagitis. An Adult Population-Based Study

Abstract

Objectives: Low-grade esophageal eosinophilia may be a manifestation of reflux disease but Eosinophilic Esophagitis (EoE) has previously been linked to Celiac disease (CD). However, population-based studies of the prevalence of EoE in patients with CD are lacking. Methods: A Population-based study of 1000 randomly selected adults in Northern Sweden. Study participants were invited to answer a questionnaire and undergo upper endoscopy. Three endoscopists performed all endoscopies during a 2.5-year period. Esophageal biopsies were obtained from 2 cm above, and at the Z-line. Any eosinophil infiltration of the epithelium was defined as esophageal eosinophilia and EoE was defined as having at least 15 eosinophils/ high power field (HPF, at magnification x40) in biopsies from the distal oesophagus. CD was defined on the basis of positive serology in parallel with mucosal abnormalities of the small intestine (increased number of intraepithelial lymphocytes and/or villous atrophy). We used Fisher's exact test to compare the prevalence of esophageal eosinophilia and EoE in patients with CD vs. controls who had also undergone upper endoscopy with biopsy. Results: Of the 1000 adults undergoing endoscopy, 48 (4.8%) had esophageal eosinophilia, 11 (1.1%) had EoE and 18 (1.8%) had CD. CD was diagnosed in 2/48 (4.2%) individuals with esophageal eosinophilia (controls: 16/952 (1.7%), p=0.21), but in none of the 11 individuals with EoE (controls: 18/989 (1.8%), p=1.0). Conclusion: This population-based study of 1000 individuals undergoing esophageal and duodenal biopsy found no increased risk of esophageal eosinophilia or EoE among individuals with CD.