Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns
Abstract Objective Severe gastrointestinal lesions are associated with a poor prognosis in eosinophilic granulomatosis with polyangiitis (EGPA). The goal of this study was to develop an effective predictive model for gastrointestinal lesions and to examine clinical patterns, associated factors, trea...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | Arthritis Research & Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13075-024-03467-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559227392327680 |
|---|---|
| author | Suying Liu Yunjiao Yang Linna Han Chengmei He Mengtao Li Xinping Tian Juan Meng Li Wang Fengchun Zhang |
| author_facet | Suying Liu Yunjiao Yang Linna Han Chengmei He Mengtao Li Xinping Tian Juan Meng Li Wang Fengchun Zhang |
| author_sort | Suying Liu |
| collection | DOAJ |
| description | Abstract Objective Severe gastrointestinal lesions are associated with a poor prognosis in eosinophilic granulomatosis with polyangiitis (EGPA). The goal of this study was to develop an effective predictive model for gastrointestinal lesions and to examine clinical patterns, associated factors, treatment, and outcomes of gastrointestinal lesions in EGPA. Methods We retrospectively enrolled 165 EGPA patients. The independent associated factors were analyzed using multivariate logistic regression. A nomogram was conducted to quantify the predictive factors. The correlation between different organ lesions was calculated to explore the clinical patterns. Results A total of 52 patients had gastrointestinal lesions, and 22 developed severe disorders. Common manifestations included abdominal pain (78%), diarrhea (40.4%), and nausea and/or vomiting (32.7%). Severe gastrointestinal lesions included hemorrhage (26.9%), ulcers (17.3%), obstruction (9.6%), and pancreatitis (5.8%). Eosinophilic tissue infiltration, weight loss, and myalgia were independently associated with gastrointestinal involvement. Patients with severe gastrointestinal lesions had a shorter duration from initial symptoms to EGPA diagnosis, less frequent asthma, and ear-nose-throat involvement, and were more likely to receive methylprednisolone pulse. Weight loss, central nervous system involvement, myalgia, and eosinophilic tissue infiltration were retained in the nomogram. An eosinophil ratio of over 19.2% identified gastrointestinal lesions. Significantly more patients with gastrointestinal involvement had a Five Factor Score ≥ 2. Five well-defined clinical models were identified, including the brain-gut pattern. Conclusions Severe gastrointestinal lesions are common in EGPA and early detection is critical. Eosinophils are an important factor associated with gastrointestinal involvement of EGPA. We developed a model to predict the risk of gastrointestinal lesions. The brain-gut pattern might deserve further investigation in EGPA. |
| format | Article |
| id | doaj-art-8ff411d9318b4b7c85cf4cd2dbd22482 |
| institution | Kabale University |
| issn | 1478-6362 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj-art-8ff411d9318b4b7c85cf4cd2dbd224822025-01-05T12:42:20ZengBMCArthritis Research & Therapy1478-63622025-01-0127111310.1186/s13075-024-03467-7Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patternsSuying Liu0Yunjiao Yang1Linna Han2Chengmei He3Mengtao Li4Xinping Tian5Juan Meng6Li Wang7Fengchun Zhang8Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, the Ministry of Education Key Laboratory, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, the Ministry of Education Key Laboratory, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesDepartment of Rheumatology and Clinical Immunology, the Third Affiliated Hospital of Chongqing Medical UniversityDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, the Ministry of Education Key Laboratory, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, the Ministry of Education Key Laboratory, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, the Ministry of Education Key Laboratory, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesDepartment of Rheumatology and Clinical Immunology, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, the Ministry of Education Key Laboratory, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, the Ministry of Education Key Laboratory, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesAbstract Objective Severe gastrointestinal lesions are associated with a poor prognosis in eosinophilic granulomatosis with polyangiitis (EGPA). The goal of this study was to develop an effective predictive model for gastrointestinal lesions and to examine clinical patterns, associated factors, treatment, and outcomes of gastrointestinal lesions in EGPA. Methods We retrospectively enrolled 165 EGPA patients. The independent associated factors were analyzed using multivariate logistic regression. A nomogram was conducted to quantify the predictive factors. The correlation between different organ lesions was calculated to explore the clinical patterns. Results A total of 52 patients had gastrointestinal lesions, and 22 developed severe disorders. Common manifestations included abdominal pain (78%), diarrhea (40.4%), and nausea and/or vomiting (32.7%). Severe gastrointestinal lesions included hemorrhage (26.9%), ulcers (17.3%), obstruction (9.6%), and pancreatitis (5.8%). Eosinophilic tissue infiltration, weight loss, and myalgia were independently associated with gastrointestinal involvement. Patients with severe gastrointestinal lesions had a shorter duration from initial symptoms to EGPA diagnosis, less frequent asthma, and ear-nose-throat involvement, and were more likely to receive methylprednisolone pulse. Weight loss, central nervous system involvement, myalgia, and eosinophilic tissue infiltration were retained in the nomogram. An eosinophil ratio of over 19.2% identified gastrointestinal lesions. Significantly more patients with gastrointestinal involvement had a Five Factor Score ≥ 2. Five well-defined clinical models were identified, including the brain-gut pattern. Conclusions Severe gastrointestinal lesions are common in EGPA and early detection is critical. Eosinophils are an important factor associated with gastrointestinal involvement of EGPA. We developed a model to predict the risk of gastrointestinal lesions. The brain-gut pattern might deserve further investigation in EGPA.https://doi.org/10.1186/s13075-024-03467-7GastrointestinalEosinophilic granulomatosis with polyangiitisEosinophilic gastroenteritisPredictionBrain-gut |
| spellingShingle | Suying Liu Yunjiao Yang Linna Han Chengmei He Mengtao Li Xinping Tian Juan Meng Li Wang Fengchun Zhang Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns Arthritis Research & Therapy Gastrointestinal Eosinophilic granulomatosis with polyangiitis Eosinophilic gastroenteritis Prediction Brain-gut |
| title | Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns |
| title_full | Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns |
| title_fullStr | Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns |
| title_full_unstemmed | Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns |
| title_short | Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns |
| title_sort | gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis a prediction model and clinical patterns |
| topic | Gastrointestinal Eosinophilic granulomatosis with polyangiitis Eosinophilic gastroenteritis Prediction Brain-gut |
| url | https://doi.org/10.1186/s13075-024-03467-7 |
| work_keys_str_mv | AT suyingliu gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns AT yunjiaoyang gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns AT linnahan gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns AT chengmeihe gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns AT mengtaoli gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns AT xinpingtian gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns AT juanmeng gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns AT liwang gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns AT fengchunzhang gastrointestinallesionsofeosinophilicgranulomatosiswithpolyangiitisapredictionmodelandclinicalpatterns |