@article{01d313b9989f44188bb769efaf75e88a,
title = "Diagnosis of Pediatric Non-Esophageal Eosinophilic Gastrointestinal Disorders by Eosinophil Peroxidase Immunohistochemistry",
abstract = "Background: Diagnosis of non-esophageal eosinophilic gastrointestinal disorders requires quantification of tissue eosinophils. Our objective was to evaluate eosinophil peroxidase (EPX) immunohistochemistry (IHC) as a method for histologic diagnosis of eosinophilic gastritis (EG) and eosinophilic duodenitis (EoD). Methods: We performed a retrospective analysis of biopsies from pediatric EG/EoD cases and controls. Subjects with EG or EoD had ≥30 eosinophils per high power field (eos/hpf) in ≥5 hpf in the stomach and/or ≥3 hpf in the duodenum, respectively. Controls had no histopathologic diagnosis recorded. Tissue eosinophil counts were assessed by hematoxylin & eosin stains. EPX stains were assessed using a unique histopathologic scoring system. Slides were digitized and EPX+ staining area/mm2 was quantified by image analysis. Results: Twenty-six EG/EoD cases and 40 controls were analyzed. EPX scores and EPX/mm2 levels were markedly elevated in EG/EoD (p ≤ 0.0001). Eosinophil density (eos/mm2) correlated strongly with EPX scores and EPX/mm2 levels in the stomach (r ≥ 0.77) and moderately with EPX scores and EPX/mm2 levels in the duodenum (r ≥ 0.52); (p < 0.0001). EPX quantification identified EG/EoD subjects with high diagnostic accuracy (EPX score: AUC = 1 for EG and EoD; EPX/mm2: AUC = 0.98 (95%CI 0.96-1) for EG, AUC = 0.91 (95%CI 0.81-1) for EoD). Conclusion: EPX-based assessment of eosinophilic inflammation may facilitate automated histologic diagnosis.",
keywords = "digital pathology, eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, image analysis",
author = "Hasan, {Shaina H.} and Steve Taylor and Shipra Garg and Buras, {Matthew R.} and Doyle, {Alfred D.} and Bauer, {Cindy S.} and Wright, {Benjamin L.} and Shauna Schroeder",
note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Phoenix Children{\textquoteright}s Hospital Foundation. BLW also reports funding from the Arizona Biomedical Research Commission (ADHS18-198880), the Mayo Foundation, and the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). CEGIR (U54 AI117804) is part of the Rare Disease Clinical Research Network (RDCRN), an initiative of the Office of Rare Diseases Research (ORDR), NCATS, and is funded through collaboration between NIAID, NIDDK, and NCATS. CEGIR is also supported by patient advocacy groups including American Partnership for Eosinophilic Disorders (APFED), Campaign Urging Research for Eosinophilic Diseases (CURED), and Eosinophilic Family Coalition (EFC). As a member of the RDCRN, CEGIR is also supported by its Data Management and Coordinating Center (DMCC) (U2CTR002818). Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr. Wright has received research funding from Allakos. Dr. Schroeder has received research funding from Allakos, Regeneron, and Takeda. Funding Information: The authors would like to thank Melissa Pecak BSN, RN for her efforts in coordinating the care of patients in the Phoenix Children?s Hospital Multidisciplinary EGID Clinic. They would also like to thank Nora Odisho, MD for her work in submitting the IRB protocol and Jamie Smith for assisting as a research coordinator. Publisher Copyright: {\textcopyright} 2021, Society for Pediatric Pathology All rights reserved.",
year = "2021",
month = nov,
doi = "10.1177/10935266211024552",
language = "English (US)",
volume = "24",
pages = "513--522",
journal = "Pediatric and Developmental Pathology",
issn = "1093-5266",
publisher = "Society for Pediatric Pathology",
number = "6",
}