Mucosal eosinophils, mast cells, and intraepithelial lymphocytes in youth with rumination syndrome.

Creator(s)

Hunter J. Friesen
John Rosen, Children's Mercy HospitalFollow
Christina M. Low Kapalu, Children's Mercy HospitalFollow
Meenal Singh
Tracy Spaeth
Jose Cocjin, Children's Mercy HospitalFollow
Craig A. Friesen, Children's Mercy HospitalFollow
Jennifer Verrill Schurman, Children’s Mercy Kansas CityFollow

Document Type

Article

Publication Date

10-2021

Identifier

DOI: 10.1111/nmo.14155

Abstract

Background: Rumination syndrome has been associated with increased duodenal eosinophils and intraepithelial lymphocytes in adults. The aims of the current study were to assess densities of antroduodenal eosinophils and mast cells and duodenal intraepithelial lymphocytes in youth with rumination syndrome and to compare cell densities in those with and without abdominal pain or early satiety.

Methods: Twenty-eight youth fulfilling Rome IV criteria for rumination syndrome who had undergone endoscopy were identified and compared to 10 controls. Antral and duodenal biopsies were assessed to determine densities of eosinophils, mast cells, and intraepithelial lymphocytes. Cell densities were also compared between rumination patients with and without abdominal pain and those with and without early satiety.

Key results: Antral mast cell (peak 18.5±6.5 vs. 12.5±2.7) and eosinophil (peak 9.6±5.2 vs. 4.9±2.1) densities were significantly greater in patients with rumination syndrome as compared to controls. Duodenal intraepithelial lymphocyte densities were also increased in rumination syndrome (18.9 ± 5.1 vs. 11.7 ± 1.5; p < .001). Associations were independent of the presence of abdominal pain or early satiety.

Conclusions and inferences: In conclusion, we found an increase in eosinophil and mast cell densities in the gastric antrum and an increase in intraepithelial lymphocytes in the duodenum in youth with rumination syndrome which was independent of the presence of abdominal pain or early satiety. These findings suggest a potential role for inflammation in the pathophysiology of rumination syndrome. Future studies should address whether treatment directed at these cells are beneficial in treating rumination syndrome.

Journal Title

Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society

Volume

33

Issue

10

First Page

14155

Last Page

14155

Keywords

eosinophils; functional gastrointestinal disorders; lymphocytes; mast cells; rumination syndrome

Recommended Citation

Friesen HJ, Rosen J, Low Kapalu C, et al. Mucosal eosinophils, mast cells, and intraepithelial lymphocytes in youth with rumination syndrome. Neurogastroenterol Motil. 2021;33(10):e14155. doi:10.1111/nmo.14155