Supplementary Material for: A MARKED EOSINOPHILIC INFILTRATION IN MUCOSA COULD BE A BETTER PREDICTIVE FACTOR FOR INTRACTABLE NON-ESOPHAGEAL EOSINOPHILIC GASTROINTESTINAL DISORDERS.

Introduction：Non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs) are rare, but their prevalence has recently increased. Although it has been reported that one-half of patients with non-EoE EGIDs have intractable clinical courses, their clinical features are not fully understood.
Methods：This is a multicenter retrospective study in which 10 institutions in Japan participated. Clinical databases from January 1998 to December 2020 were reviewed to identify patients with non-EoE EGIDs. A total of 44 patients were identified; they were divided into two groups based on their clinical course: An intractable and a non-intractable group. The clinical features were compared between the two groups by a logistic regression analysis. Remarkable eosinophilic infiltration (REI) was defined histologically when the maximal counts of mucosal eosinophils reached a threshold level in the respective area of biopsy.
Results：Prevalence of drug allergy, and eosinophil counts more than 500/μl (EOS), vomiting symptoms (Vomit), abnormalities of the stomach, duodenum and jejunum on computed tomography (UACT) and REI were significantly different between the two groups. Among the factors that were potentially associated with an intractable clinical course, logistic regression revealed that REI, EOS, and UACT were significant factors. Based on an analysis of the area under the ROC curve, a combination of REI and EOS had the lowest AIC, indicating the best model to predict an intractable clinical course.
Conclusions：REI may predict an intractable course in patients with non-EoE EGIDs. In addition, the combination of REI and EOS was a better predictor than REI alone.

Introduction：非食管嗜酸性粒细胞性胃肠道疾病（non-esophageal eosinophilic gastrointestinal disorders, non-EoE EGIDs）虽属罕见病，但近年患病率呈上升趋势。已有研究报道，约半数非EoE EGIDs患者的临床病程呈难治性，但目前对其临床特征尚未完全明确。
Methods：本研究为一项多中心回顾性研究，共纳入日本10家医疗机构参与。研究检索了1998年1月至2020年12月的临床数据库，以筛选非EoE EGIDs患者。最终共纳入44例患者，并根据临床病程分为难治性组与非难治性组。采用logistic回归分析比较两组患者的临床特征。显著嗜酸性粒细胞浸润（remarkable eosinophilic infiltration, REI）经组织病理学定义为：活检相应区域的黏膜嗜酸性粒细胞最大计数达到阈值水平。
Results：两组患者的药物过敏患病率、外周血嗜酸性粒细胞计数＞500/μl（EOS）、呕吐症状（Vomit）、计算机断层扫描（computed tomography, UACT）提示胃、十二指肠及空肠异常，以及REI的差异均具有统计学意义。在与难治性临床病程潜在相关的诸多因素中，logistic回归分析显示REI、EOS及UACT为显著相关因素。基于受试者工作特征曲线（ROC曲线）下面积分析，REI与EOS联合模型的赤池信息准则（AIC）值最低，提示该模型为预测难治性病程的最优预测模型。
Conclusions：REI可用于预测非EoE EGIDs患者的难治性病程；此外，REI与EOS联合的预测效能优于单一REI指标。