Clinical Implications of Low-grade Duodenal Eosinophilia in Functional Dyspepsia

FERNANDO JAVIER BARREYRO; MARIA VIRGINA CARONIA; KARINA ELIZONDO; NICOLAS SANCHEZ; GRACIELA JORDÁ; ADOLFO SCHNEIDER; PEDRO DARÍO ZAPATA

J Clin Gastroenterol

Wolkers Kluwer

Año: 2022 vol. 2022

Background: Functional dyspepsia (FD) is a multifactorial disorder with no targeted therapy. Duodenal eosinophilia and low-grade inflammation are potential pathogenic mechanisms. However, theimpact of duodenal eosinophils (D-EO) histologic evaluation in real-life clinical practice was not explored.Aim: To evaluate the clinical utility of D-EO and low-grade inflammation in FD in real-life practice.Materials and Methods: A multicenter prospective study was conducted. A total of 636 patients who meet Rome-III criteria were selected before upper endoscopy and 516 patients were included after normal endoscopy were assessed. Clinical parameters, Helicobacter pylori (H. pylori), and duodenal histology were evaluated.Results: FD subtypes were 231 (45%) patients who had epigastric pain syndrome (EPS), 168 (33%) postprandial distress syndrome (PDS), and 117 (22%) EPS/PDS overlap. Two hundred fifty-nine(50.3%) patients were H. pylori+. Histologic duodenal grading of chronic inflammation and intraepithelial lymphocytes showed no difference between FD subtypes. Increased in D-EO densities (> 10 per high power field) was significant in PDS compared with EPS and EPS/PDS overlap subtypes. The odds ratio of PDS in subjects with duodenal eosinophilia densities was 2.28 (95% CI, 1.66-3.14;P