Eosinophilic Esophagitis, CRS Show Associations as Comorbid Conditions

What is the relative risk of having eosinophilic esophagitis (EoE) coexist with chronic rhinosinusitis (CRS) in probands and their families?

Background: EoE is a disease process that is defined by its eosinophilia and inflammatory changes. CRS is also an inflammatory disease, and eosinophilia has been shown to play one possible role in the development of certain subsets. EoE and CRS may share a common etiopathogenesis due to uncontrolled inflammation in their development. It is not known whether or not EoE and CRS share a familial link and are found to be prevalent as comorbid conditions.

Study design: Retrospective observational cohort study of CRS and EoE patients diagnosed at any age between 2008 and 2012 with population-based matched controls.

Setting: Utah Population Database, a genealogical database linked to medical records.

Synopsis: CRS probands were equally divided (48.6% male, 51.4% female), with the majority of the patients between 31 and 50 years old. EoE probands were two-thirds male and one-third female, with the highest percentage between ages 31 and 50. In the CRS probands, there was a 3.44 times increased risk of having EoE. First-degree relatives of CRS probands had a 1.45 times increased risk of having EoE, while spouses of these probands had 1.44 times increased risk of having EoE. When the CRS group was divided into subgroups with and without nasal polyposis, similar increased risks were found for the nasal poly-posis group in EoE probands (3.4-fold higher), first-degree relatives (1.6-fold higher), and spouses (1.6-fold higher). EoE probands were 2.86 times more likely to have CRS than matched controls. Limitations included possible variations in outpatient clinic versus ambulatory surgery and inpatient visit diagnosis, and a potential disease awareness bias as relatives and spouses of probands are more aware of the symptom profile and are more likely to seek earlier evaluation.

Bottom line: An association between CRS and EoE as comorbid conditions suggests that a familial component is contributing to the etiology of both diseases. Data support the possibility that an environmental component may exist.

Citation: Padia R, Curtin K, Peterson K, Orlandi RR, Alt J. Eosinophilic esophagitis strongly linked to chronic rhinosinusitis. Laryngoscope. 2016;126:1279-1283.