OBJECTIVES:

Eosinophilic Esophagitis (EoE) is a chronic immune mediated condition involving eosinophils leading to esophageal dysfunction. Although EoE is found in up to 7% of patients undergoing endoscopy and is increasing in prevalence, its pathogenesis remains poorly understood. In this retrospective multicenter study, we investigated the incidence and risk factors for comorbid autoimmune diseases (AiD) using Cerner Health Facts, a national longitudinal database representing approximately 69 million patients.

METHODS:

All patients 18 years of age or older with EoE were included in our analysis. Patient characteristics were evaluated as potential risk factors for AiD comorbidity using multivariable regression built using all variables that had a p-value less or equal to 0.05.

RESULTS:

We identified 8,535 patients with EoE. Mean age was 44.16±16.64 years and 42.44% (3,622) were female. In terms of race, 85.24% (7,275) were white and 6.03% (515) were African American. Overall, 13.38% (1,142) of patients with EoE had at least one comorbid AiD. The most common AiD in those with EoE was autoimmune thyroid disease (577) followed by ulcerative colitis (199) and rheumatoid arthritis (89). On multivariable regression, the factors associated with a higher risk of AID included female gender (OR 2.73), steroid use (OR 2.70), type2-diabetes (OR 1.88), long-term medication use (OR 1.87), digestive comorbidities (OR 1.59), anxiety (OR 1.47), nicotine use (OR 1.47), hyperlipidemia (OR 1.42), asthma (OR 1.36) and hypertension (OR 1.23).

CONCLUSIONS:

We utilized a national database of patients with diagnosed EoE to identify the incidence and risk factors for comorbid AiD. Autoimmune thyroid disease and ulcerative colitis were the most common AiDs comorbid with EoE. The greatest risk factor for comorbid AiDs was female gender. The high prevalence of AiD in patients with EoE suggests potential overlap in immune dysregulation and warrants broader consideration and evaluation for AiD in the setting of EoE.