Original article—alimentary tractNon-ulcer Dyspepsia and Duodenal Eosinophilia: An Adult Endoscopic Population-Based Case-Control Study
Section snippets
Setting
The study population was obtained from 2 neighboring communities in Northern Sweden, Kalix and Haparanda,19, 20, 21, 22, 23 with 18,408 and 10,580 inhabitants, respectively (as of December 1998). The distribution of age and sex was similar to the national average in Sweden in both communities.19 The Kalixanda study was approved by the Umeå University ethics committee and conducted in accordance with the revised Declaration of Helsinki.
Sampling
By using the computerized national population register,
Cases and Controls
No association of case/control status and demographic variables was observed, and in particular the prevalence of H pylori was similar (Table 1).
Upper Gastrointestinal Pathology
The mean intraepithelial lymphocyte count in the duodenum in non-ulcer dyspepsia cases was 13 (SD, ±6) compared with 13 (SD, ±6) in controls (P = .94, adjusting for age, sex, and H pylori status). Only 1 case of active duodenitis was seen and this was in a control H pylori–positive subject. No subject had visible intestinal parasites or cancer. None of
Discussion
We found a significant positive association for an eosinophil infiltrate in the duodenum with non-ulcer (functional) dyspepsia. There were greater odds for non-ulcer dyspepsia in adult subjects with increased duodenal eosinophil counts, adjusting for age, sex, and H pylori status. Duodenal eosinophilia was linked to specific dyspepsia symptoms. Furthermore, in those with increased gastric eosinophils, a greater odds for H pylori was observed, suggesting that infection may up-regulate eosinophil
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Supported in part by the Swedish Research Council; the Swedish Society of Medicine; Mag-tarm sjukas förbund, Norrbotten County Council, Sweden; AstraZeneca R&D, Sweden; and the University of Sydney.