S481 Deciphering the Intersection of Celiac Disease and Eosinophilic Esophagitis in Pediatric and Adult Patients: Insights From a Global Cohort
Notice bibliographique
Résumé
Introduction: Eosinophilic esophagitis (EoE) and Celiac Disease (CD) are helper T-cell driven chronic inflammatory gastrointestinal disorders. Previous studies have hinted at a possible association between the two, yet connections on a large scale remain unexplored. This study aimed to examine and characterize EoE and CD connections in a real-world population database. Methods: We queried TriNetX, a global healthcare database for patients based on ICD-10 codes. We divided subjects into 6 cohorts, based on their diagnosis of CD and EoE and age from April 28th, 2003 to April 28th, 2023. EOE and Celiac diagnoses had to be documented twice at least 1 month apart to ensure accuracy as previously described by other authors. Patient demographics, prevalence, incidence, and characteristics of each cohort were extracted over 20 years. Attributes were compared using chi-square testing with significance set at P = 0.05. Results: Analysis demonstrated a higher incidence (511/100,000) and prevalence (3.6%) of EoE in pediatric celiac patients compared to adult celiac patients (146/100,000 and 1.4%, respectively, P < 0.001). Pediatric celiac patients did not differ in incidence of EoE in males and females (P = 0.4448), while among adult celiac patients, females (59%) were more affected (P = 0.001). Geographically in USA, there is a significant difference in the distribution of EoE cases among pediatric celiac patients, adult celiac patients, and the general adult population by region (P = 0.004916). Descriptively, the Midwest appears to have the highest number of cases in both pediatric and adult celiac patients, with the West having the lowest number in the pediatric population and the South having the lowest number in the adult population. The majority of EoE cases in celiac patients were White (82% pediatric, 89% adult). A higher prevalence of asthma, allergic rhinitis, and atopic dermatitis was noted among EoE patients (Table 1). Conclusion: The interplay between EoE and CD reveals a complex relationship, with higher EoE prevalence observed in adult females with CD with no difference among the pediatric population. Notably, the correlation with Th2 mediated conditions underscores a potential crosstalk among these disorders. Geographical variations suggest environmental and dietary influence on EoE development. These insights, which highlight shared disease mechanisms, have crucial implications for patient diagnosis, treatment, and management strategies. Table 1. - Descriptive characteristics of Celiac Disease patients with and without the diagnosis of Eosinophilic Esophagitis from April 28th, 2003 – April 28th, 2023 Peds Celiac (N%) Adults Celiac (N%) Gen Adult pop (N%) Incidence of EoE per 10^5 per year 511 146 15 Prevalence, % 3.6 1.4 0.029 EOE Status EoE No EoE EoE No EoE EoE No EoE Number 480 23,831 503 64,231 29,103 93,534,081 Age, y ± SD 15.9 ± 5.41 19.3 ± 8.39 40.2 ± 15.8 50.9 ± 19.3 44.3 ± 15.9 52.5 ± 18.6 Sex Male 251 (52) 8,004 (34) 206 (41) 16,781 (26) 17,088 (55) 41,793,438 (45) Female 229 (48) 15,817 (66) 297 (59) 47,442 (74) 12,011 (45) 51,557,927 (55) Region Northeast 107 (22) 6,099 (26) 162 (32) 22,702 (35) 9,471 (33) 18,676,929 (20) Midwest 145 (30) 6,251 (26) 125 (25) 10,592 (16) 6,936 (24) 8,813,549 (9) South 140 (29) 6,625 (28) 103 (20) 15,765 (25) 7,243 (25) 27,991,281 (30) West 79 (16) 3,272 (14) 109 (21) 8,759 (14) 5,080 (14) 7,935,841 (8) Unknown 1-10 (2) 41 (1) 1-10 (2) 478 (1) 91 (1) 3,781,839 (4) Ex-US regions 0 1,543 (6) 0 5,935 (9) 282 (1) 26,595,473 (28) Race White 398 (82) 19,006 (80) 451 (89) 53,903 (84) 24,861 (85) 42,018,710 (45) African American 1-10 (2) 439 (2) 14 (2) 1,381 (2) 1,061 (4) 9,099,019 (10) Asian 1-10 (2) 283 (1) 1-10 (1) 734 (1) 287 (1) 2,257,940 (2) American Indian 1-10 (2) 71 (0) 1-10 (1) 132 (0) 79 (0) 288,725 (0) Native Hawaiian 1-10 (2) 17 (0) 1-10 (1) 22 (0) 12 (0) 110,501 (0) Unknown 64 (13) 4,015 (17) 34 (6) 8,059 (13) 2,803 (10) 39,759,186 (43) Ethnicity Hispanic or Latino 26 (5) 1,269 (5) 14 (3) 2,012 (3) 833 (3) 5,015,316 (5) Non-Hispanic or Latino 403 (84) 17,722 (75) 400 (79) 42,248 (66) 22,587 (78) 34,088,581 (37) Unknown 51 (11) 4,840 (2) 89 (18) 19,971 (31) 5,683 (19) 54,430,184 (58) Diagnoses Asthma 156 (33) 3,879 (16) 181 (36) 12,728 (20) 8,890 (31) 40,226 (4) Atopic Dermatitis 60 (13) 907 (4) 24 (5) 1,462 (2) 1,202 (4) 4,405 (0) RA 1-10 (2) 135 (1) 23 (5) 2,084 (3) 395 (1) 5,590 (1) Autoimmune hepatitis 1-10 (2) 71 (0) 1-10 (1) 479 (1) 45 (0) 384 (0) Down syndrome 1-10 (2) 830 (3) 1-10 (1) 765 (1) 28 (0) 607 (0) Turner Syndrome 1-10 (2) 139 (1) 1-10 (1) 150 (0) 1-10 (0) 163 (0) T1DM 51 (11) 3,821 (16) 23 (5) 4,966 (8) 419 (1) 8,265 (1) Autoimmune thyroiditis 23 (5) 1,548 (6) 40 (8) 4,219 (7) 638 (2) 3,083 (0) Allergic rhinitis 170 (35) 3,598 (15) 185 (37) 13,049 (20) 10,351 (36) 33,846 (3) Chronic rhinitis 48 (10) 961 (4) 45 (9) 3,165 (5) 2,503 (9) 6,495 (1) TriNetX does report patient totals less than 10 and therefore are indicated by “1-10” on Table.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».