Abstract

Peripheral Blood Eosinophilia and Long-term Severity in Pediatric-Onset Inflammatory Bowel Disease

Inflamm Bowel Dis. 2020 Nov 19;26(12):1890-1900. doi: 10.1093/ibd/izz323.

Krishnapriya Marangattu Prathapan 1, Claudia Ramos Rivers 2, Alyce Anderson 3, Filippos Koutroumpakis 2, Ioannis E Koutroubakis 2, Dmitriy Babichenko 4, Xiaoqing Tan 5, Gong Tang 5, Marc Schwartz 2, Siobhan Proksell 2, Elyse Johnston 2, Jana G Hashash 2, Michael Dunn 2, Annette Wilson 2, Arthur Barrie 2, Janet Harrison 2, Douglas Hartman 6, Sandra C Kim 1, David G Binion 2

 
     

Author information

  • 1Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • 2Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • 3University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA.
  • 4School of Information Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • 5Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • 6Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Abstract

Background: Peripheral blood eosinophilia (PBE) is a biomarker of an aggressive multiyear natural history in adults with inflammatory bowel diseases (IBDs). Additionally, PBE at diagnosis is associated with higher disease activity in pediatric-onset IBD. We sought to determine if PBE can function as a biomarker of long-term disease severity in pediatric-onset IBD patients who are followed into adulthood.

Methods: We analyzed a consented, prospective, natural history IBD registry at an adult tertiary center from 2009 to 2018. Prevalence of PBE was evaluated in both pediatric- and adult-onset IBD patients. Demographics, clinical characteristics, and health care utilization data were compared in patients with and without PBE.

Results: Among 2800 adult IBD patients, 23.4% had pediatric-onset disease. PBE was found in 34% of the pediatric-onset patients compared with 26.8% of the adult-onset IBD patients (P < 0.001). In the pediatric-onset IBD cohort, PBE was associated with higher rates of allergies (P < 0.0001), but not of asthma, allergic rhinitis, or primary sclerosing cholangitis. In the adult IBD patients with pediatric-onset disease, PBE was associated with higher rates of C-reactive protein elevation (P < 0.0001), erythrocyte sedimentation rate elevation (P < 0.0001), higher health care utilization, and higher average health care charges per year (P < 0.00001).

Conclusions: Peripheral blood eosinophilia was more prevalent in adult IBD patients with pediatric-onset compared with adult-onset disease. Among all IBD patients with long-term follow-up, PBE defined a subgroup with more severe illness. These data suggest that PBE may be a biomarker for a high-risk subgroup with high cost trajectory and long-term severity in pediatric-onset IBD that persists into adulthood.

© Copyright 2013-2021 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.