P0411 - Deciphering the Intersection of Celiac Disease and Eosinophilic Esophagitis in Pediatric and Adult Patients: Insights From a Global Cohort

Mohamed Aly, BSc¹, Benjamin D. Liu, MD², Gengqing Song, MD^3
1Schulich School of Medicine and Dentistry, London, ON, Canada; ²MetroHealth, Cleveland, OH; ³MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH

Introduction: Eosinophilic esophagitis (EoE) and Celiac Disease (CD) are helper T-cell driven chronic inflammatory gastrointestinal disorders. Previous studies have hinted at a possible association between the two, yet connections on a large scale remain unexplored. This study aimed to examine and characterize EoE and CD connections in a real-world population database.

Methods: We queried TriNetX, a global healthcare database for patients based on ICD-10 codes. We divided subjects into six cohorts, based on their diagnosis of CD and EoE and age from April 28th, 2003 to April 28th, 2023. EOE and Celiac diagnoses had to be documented twice at least 1 month apart to ensure accuracy as previously described by other authors. Patient demographics, prevalence, incidence, and characteristics of each cohort were extracted over 20 years. Attributes were compared using chi-square testing with significance set at P = 0.05.

Results: Analysis demonstrated a higher incidence (511/100,000) and prevalence (3.6%) of EoE in pediatric celiac patients compared to adult celiac patients (146/100,000 and 1.4%, respectively, P < 0.001). Pediatric celiac patients did not differ in incidence of EoE in males and females (P = 0.4448), while among adult celiac patients, females (59%) were more affected (P = 0.001). Geographically in USA, there is a significant difference in the distribution of EoE cases among pediatric celiac patients, adult celiac patients, and the general adult population by region (P = 0.004916). Descriptively, the Midwest appears to have the highest number of cases in both pediatric and adult celiac patients, with the West having the lowest number in the pediatric population and the South having the lowest number in the adult population. The majority of EoE cases in celiac patients were White (82% pediatric, 89% adult). A higher prevalence of asthma, allergic rhinitis, and atopic dermatitis was noted among EoE patients (Table 1).

Discussion: The interplay between EoE and CD reveals a complex relationship, with higher EoE prevalence observed in adult females with CD with no difference among the pediatric population. Notably, the correlation with Th2 mediated conditions underscores a potential crosstalk among these disorders. Geographical variations suggest environmental and dietary influence on EoE development. These insights, which highlight shared disease mechanisms, have crucial implications for patient diagnosis, treatment, and management strategies.



Disclosures:


Mohamed Aly, BSc¹, Benjamin D. Liu, MD², Gengqing Song, MD³. P0411 - Deciphering the Intersection of Celiac Disease and Eosinophilic Esophagitis in Pediatric and Adult Patients: Insights From a Global Cohort, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.