Hirano, IkuoCollins, Margaret H.King, EileenSun, QinChehade, MirnaAbonia, J. PabloBonis, Peter A.Capocelli, Kelly E.Dellon, Evan S.Falk, Gary W.Gonsalves, NirmalaGupta, Sandeep K.Leung, JohnKatzka, DavidMenard-Katcher, PaulKhoury, PaneezKlion, AmyMukkada, Vincent A.Peterson, KathrynShoda, TetsuoRudman-Spergel, Amanda K.Spergel, Jonathan A.Yang, Guang-YuRothenberg, Marc E.Aceves, Seema S.Furuta, Glenn T.CEGIR investigators2023-11-162023-11-162022Hirano I, Collins MH, King E, et al. Prospective Endoscopic Activity Assessment for Eosinophilic Gastritis in a Multisite Cohort. Am J Gastroenterol. 2022;117(3):413-423. doi:10.14309/ajg.0000000000001625https://hdl.handle.net/1805/37099Introduction: Eosinophilic gastritis (EG) is a chronic inflammatory disease of the stomach characterized by eosinophil-predominant gastric mucosal inflammation and gastrointestinal symptoms. The aim of this study was to prospectively evaluate endoscopic features in a large series of children and adults with EG to better understand the endoscopic manifestations and develop a standardized instrument for investigations. Methods: Data were prospectively collected as part of the Consortium for Eosinophilic Gastrointestinal Disease Researchers, a national collaborative network. Endoscopic features were prospectively recorded using a system specifically developed for EG, the EG Endoscopic Reference System (EG-REFS). Correlations were made between EG-REFS and clinical and histologic features. Results: Of 98 patients with EG, 65 underwent assessments using EG-REFS. The most common findings were erythema (72%), raised lesions (49%), erosions (46%), and granularity (35%); only 8% of patients with active histology (≥30 eosinophils/high-power field) exhibited no endoscopic findings. A strong correlation between EG-REFS scores and physician global assessment of endoscopy severity was demonstrated (Spearman r = 0.84, P < 0.0001). The overall score and specific components of EG-REFS were more common in the antrum than in the fundus or body. EG-REFS severity was significantly correlated with active histology, defined by a threshold of ≥30 eosinophils/high-power field (P = 0.0002). Discussion: Prospective application of EG-REFS identified gastric features with a strong correlation with physician global assessment of endoscopic activity in EG. Endoscopic features demonstrated greater severity in patients with active histology and a predilection for the gastric antrum. Further development of EG-REFS should improve its utility in clinical studies.en-USPublisher PolicyEosinophilic gastritisEosinophilic gastroenteritisEosinophilic gastrointestinal diseaseGastroesophageal reflux diseaseArticle