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News

Eosinophilic esophagitis may not be associated with celiac disease

September's issue of the Alimentary Pharmacology & Therapeutics reviews the association between eosinophilic esophagitis and celiac disease.

News image

The relationship between eosinophilic esophagitis and celiac disease remains controversial, with studies yielding varied results.

Dr Lucendo and colleagues from Spain systematically reviewed the evidence of a possible association between both diseases.

Electronic searches were performed with keywords relating to eosinophilic esophagitis and celiac disease in the MEDLINE, EMBASE and SCOPUS databases.

Summary estimates were calculated.

The team used a random-effects model depending on heterogeneity (I2).

Publication bias was assessed with the aid of funnel plot analysis, along with the Begg–Mazumdar, Harbord and Egger tests.
The prevalence of eosinophilic esophagitis in celiac disease ranged from 0% to 11%
Alimentary Pharmacology & Therapeutics

The researchers identified 197 references, of which 30 were included in the quantitative summary, with most of these presenting methodological inconsistencies.

Significant publication bias in favour of short studies reporting positive associations between both diseases was documented.

The team found that the prevalence of eosinophilic esophagitis in celiac disease ranged from 0% to 11%.

Prevalence of celiac disease in eosinophilic esophagitis varied between 0.2% and 57%.

The research team observed that 1 high-quality, prospective, randomly selected, population-based study documented a 1% prevalence of celiac disease, with no patients presenting eosinophilic esophagitis.

Clinical and methodological heterogeneity hindered the performance of quantitative summaries for prevalence data.

The team noted that a gluten-free diet was effective in achieving histological remission of eosinophilic esophagitis in 32% of celiac patients, which was similar to that expected for wheat elimination in eosinophilic esophagitis patients.

Dr Lucendo's team comments, "While a lack of valid studies prevents us from completely ruling out a true association between eosinophilic esophagitis and celiac disease, currently available evidence does not support this hypothesis."

"Indeed, the only epidemiological study with sufficient validity points to the independence of both diseases."

Aliment Pharmacol Ther 2014: 40(5): 422–434
21 August 2014

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