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Techniques in Coloproctology

, Volume 22, Issue 12, pp 941–946 | Cite as

Colonic hypereosinophilia in ulcerative colitis may help to predict the failure of steroid therapy

  • Giuseppe Leoncini
  • Vincenzo Villanacci
  • Maria Grazia Marin
  • Valentina Crisafulli
  • Moris Cadei
  • Elisabetta Antonelli
  • Claudio Leoci
  • Gabrio BassottiEmail author
Original Article

Abstract

Background

Although glucocorticosteroids (GS) and mesalazine are effective and widely employed to treat moderate-to-severe ulcerative colitis (UC), information regarding the factors responsible for response to such therapy is still scarce. One of these factors is thought to be an increased number of mucosal eosinophils. The aim of our study was to determine whether the presence of hypereosinophilia in colonic mucosa of UC patients might influence the short-term response to l treatment with GS and mesasalazine.

Methods

Clinical, endoscopic, and pathologic data from patients with a recent diagnosis of moderate UC, who had not undergone treatment, were obtained, and the short-term outcome after 1 month of conventional first-line treatment (mesalazine plus GS) was evaluated.

Results

There were 53 patients with a median age of 37 years (95% CI 30–47).Overall, at the end of treatment period 16 (30%) patients responded, whereas a response was not observed in the other 37 (70%) patients. Interestingly, all patients of this latter group had colonic mucosal hypereosinophilia. No significant differences were found between the two groups concerning sex and age at diagnosis, but hypereosinophilia was inversely correlated with the duration of the disease (p = 0.054), and significantly correlated to the localization of UC (p = 0.0023). In addition, The Mayo score was significantly higher in patients with hypereosinophilia (median 8; 95% CI 8–9;) when compared to patients without hypereosinophilia (median 7; 95% CI 7–7, p < 0.0001) including the Mayo endoscopic subscore (median 3; 95% CI 2–3 vs median 2; 95% CI 2–2, respectively; p = 0.007).

Conclusions

The presence of colonic mucosal hypereosinophilia may be useful to predict the short-term outcome to conventional first-line therapy in treatment-naïve UC patients. It remains to be seen whether this might be important in modifying the first-line therapy in this subgroup of patients.

Keywords

Eosinophils Outcome Intestinal Mucosa Ulcerative colitis Treatment 

Notes

Compliance with ethical standards

Conflict of interest

Authors declares that they have no conflicts of interest.

Ethical approval

Since this was a retrospective study, no patient identification was needed, clinical and pathologic data were completely anonymized and no study-driven clinical intervention was performed. Therefore, our Institutional Review Board waived formal review and approval, deeming the study to be an extension of the existing procedures.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Giuseppe Leoncini
    • 1
  • Vincenzo Villanacci
    • 2
  • Maria Grazia Marin
    • 3
  • Valentina Crisafulli
    • 2
  • Moris Cadei
    • 2
  • Elisabetta Antonelli
    • 4
  • Claudio Leoci
    • 5
  • Gabrio Bassotti
    • 6
    • 7
    Email author
  1. 1.Pathology UnitASST del Garda, Desenzano del Garda (Brescia)BresciaItaly
  2. 2.Pathology UnitASST Spedali CiviliBresciaItaly
  3. 3.Department of Laboratory MedicineASST del Garda, Desenzano del Garda (Brescia)BresciaItaly
  4. 4.Gastroenterology UnitPerugia General HospitalPerugiaItaly
  5. 5.Department of Gastroenterology and Digestive EndoscopyASST del Garda, Desenzano del Garda (Brescia)BresciaItaly
  6. 6.Gastroenterology, Hepatology and Digestive Endoscopy Section, Department of MedicineUniversity of Perugia Medical SchoolPerugiaItaly
  7. 7.Clinica di Gastroenterologia ed EpatologiaOspedale S.Maria della MisericordiaPerugiaItaly

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