Zhirong Du,1 Ji Li,2 Weixun Zhou,3 Yuxiang Zhi1 

1Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, 100730, People’s Republic of China; 2Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China; 3Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China

Correspondence: Yuxiang Zhi, Department of Allergy, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Street, Wangfujing, Beijing, 100730, People’s Republic of China, Email yuxiang_zhi@126.com

Background: Eosinophilic gastrointestinal disorders (EGIDs) are chronic immune-mediated conditions characterized by pathological eosinophilic infiltration. The clinical features and therapies for eosinophilic esophagitis (EoE) vary between children and adults. However, there is limited comparison of non-EoE EGIDs across different ages of disease onset.
Methods: We retrospectively analyzed data that included 94 patients (12 juveniles, 57 young adults, and 23 older adults) with a history of non-EoE EGIDs managed in a tertiary hospital.
Results: The study included patients with a mean onset age of 36.6 years, 52.1% of whom had allergic comorbidities. Diarrhea was more common in young adults (18– 49 years), while nausea and vomiting were predominant in juveniles (0– 17 years) compared to older adults (≥ 50 years). Reduced flatulence and/or defecation were less common in young adults. Ascites were less frequent in older adults. Notably, patients with the same affected gastrointestinal site also exhibited varying manifestations across age groups: young adults with gastric or ileal involvement had higher diarrhea rates (64% and 68.4%, respectively, p < 0.05), while juveniles with gastric/duodenal involvement exhibited higher nausea, vomiting, and ascites, and those with ileal involvement showed higher ascites (p =0.031). Young adults with colonic involvement had reduced flatulence/defecation less frequently (p = 0.005). Juveniles had significantly higher peripheral eosinophil counts (p = 0.040), and higher total serum IgE levels (p =0.002) compared to older adults. Serum albumin levels were significantly higher, and erythrocyte sedimentation rate (ESR) was significantly lower in the juvenile group compared to the young adult group (p = 0.004, p = 0.045) and the older adult group (p = 0.002, p = 0.002).
Conclusion: Clinical phenotypes of patients with non-EoE EGIDs vary by age of onset. A comprehensive understanding of the features in symptoms and therapies across different age groups can help accelerate diagnosis and enhance patient care.

Keywords: eosinophilic gastrointestinal disorders, eosinophilic esophagitis, glucocorticoid