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Diagnostic role of fractional exhaled nitric oxide in pediatric eosinophilic esophagitis, relationship with gastric and duodenal eosinophils

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World Journal of Gastrointestinal Endoscopy 2023年第5期15卷 407-419页

作者： panamdeep kaur Rachel Chevalier Craig Friesen Jamie Ryan Ashley Sherman Stephanie Page Department of Pediatric Gastroenterology Connecticut Children’s Medical CenterUniversity of Connecticut School of MedicineHartfordConnecticutCT 06106United States Department of Pediatric Gastroenterology Children's Mercy Kansas CityUniversity of Missouri-Kansas City School of MedicineKansas CityMissouriMO 64108United States Department of Pediatrics University of Kansas School of MedicineKansas CityKansasKS 66160United States Department of Biostatistics Children's Mercy Kansas CityKansas CityMissouriMO 64108United States Department of Pediatric Gastroenterology Midwest Pediatric SpecialistsOverland ParkKansasKS 66215United States

BACKGROUND Eosinophilic esophagitis(EoE)is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies.A non-invasive and cost-effective alternative for management of EoE is being *** studies assessing utility of fractional exhaled nitric oxide(FeNO)in EoE were low *** investigated the contribution of eosinophilic inflammation of the stomach and duodenum to *** To assess the utility of FeNO as a non-invasive biomarker of esophageal eosinophilic inflammation for monitoring disease *** Patients aged 6-21 years undergoing scheduled upper endoscopy with biopsy for suspected EoE were recruited in our observational *** on steroids and with persistent asthma requiring daily controller medication were *** measurements were obtained in duplicate using a chemiluminescence nitric oxide analyzer(NIOX MINO,Aerocrine,Inc.;Stockholm,Sweden)prior to *** on the esophageal peak eosinophil count(PEC)/high power field on biopsy,patients were classified as EoE(PEC≥15)or control(PEC≤14).Mean FeNO levels were correlated with presence or absence of EoE,eosinophil counts on esophageal biopsy,and abnormal downstream eosinophilia in the stomach(PEC≥10)and duodenum(PEC≥20).Wilcoxon rank-sum test,Spearman correlation,and logistic regression were used for analysis.P value<0.05 was considered *** We recruited a total of 134 patients,of which 45 were diagnosed with EoE by *** median interquartile range FeNO level was 17 parts per billion(11-37,range:7-81)in the EoE group and 12 parts per billion(8-19,range:5-71)in the control *** adjusting for atopic diseases,EoE patients had significantly higher FeNO levels as compared to patients without EoE(Z=3.33,P<0.001).A weak yet statistically significant positive association was found between the number of esophageal eosinophils and FeNO levels(r=0.30,P<0.005).On subgroup analysis within the EoE cohort,h

关键词： Nitric oxide Fractional exhaled nitric oxide Eosinophilic esophagitis Esophagus Pediatric Gastroenterology

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