Human Pathology Reports (Sep 2022)
Non-esophageal eosinophilic gastrointestinal disorders
Abstract
Eosinophilic gastrointestinal disorders (EGIDs) refer to a rare group of chronic immune-mediated diseases of the tubular gastrointestinal tract, characterized clinically by gastrointestinal dysfunction and symptoms, and histologically by eosinophil-predominant immune response with unknown etiology. They include eosinophilic esophagitis (EoE), gastritis (EoG), enteritis (EoN) and colitis (EoC) based on sites involved according the latest International Consensus Recommendations for Eosinophilic Gastrointestinal Disease Nomenclature (2022 ICR-EGID Nomenclature). EoE is the most well-studied entity of EGIDs with established diagnostic criteria, 3 endotypes (OMEGA study), histology scoring system (EoEHSS), randomized clinical trials (SOFEED study), and non-IgE-mediated hypersensitive reaction as its presumed pathogenesis. Non-esophageal gastrointestinal disorders (Non-EoE EGIDs), although reported more than four decades earlier than EoE, are however less well-understood. The rarity of these diseases, heterogeneous clinical presentations, broad differential diagnosis, and most importantly, the lack of a consensus on diagnostic criteria and clinical management have all contributed to an incomplete understanding of these diseases. This review focuses on diagnosis of Non-EoE EGIDs and discusses several challenges we face in daily practice from a pathologist perspective.
