Reviewer's report
Title:The Association Between Celiac Disease and Eosinophilic Esophagitis in
Children and Adults
Version: 1Date:18 March 2013
Reviewer: James Franciosi
Reviewer's report:
The authors present an interesting manuscript reporting a population-based
study investigating the incidence rates of Celiac Disease and EoE (really,
esophageal eosinophilia). Overall the manuscript is well written and statistically
sound. I submit the following Major Compulsory Revisions
1. In the first paragraph, the authors report that the incidence of EoE has risen
dramatically over the past decade, yet the data in table 1 do not show this to be
the case at least for the pediatric subpopulation.
2. The inclusion of both Table 1 and Figure 1 appear redudant. Figures do not
have Titles provided
3. The authors need to explore further the difference in IR in total vs pediatric
cohorts- have the adult biopsy practices changed in their adult groups that may
explain these apparent rises as ascertainment bias?
DeBrosse, C.W., Collins, M.H., Buckmeier Butz, B.K., Allen, C.L., King, E.C.,
Assa'ad, A.H., Abonia, J.P., Putnam, P.E., Rothenberg, M.E., Franciosi, JP.
Identification, epidemiology, and chronicity of pediatric esophageal eosinophilia,
1982-1999. J Allergy Clin Immunol. 2010 Jul;125 (1):112-9
4. The current EoE consensus guidelines (Liacouras, JACI, 2011) note Celiac
Disease as associated with Esophageal Eosinophilia as distinct from EoE. This
combined with the relatively unknown clinical criteria for EoE in the 3 subjects,
really suggest that these subjects are best termed as having esophageal
eosinophilia. Certainly a controversial topic, but one could argue that PPI
responsive esophageal eosinophilia has not been excluded, and Esophageal
eosinophilia in the context of duodenitis does not meet the defintions for EoE
5. Table 2 - what happened to the esophageal eosinophilia when wheat was
eliminated and the duodenitis resolved on repeat endoscopy?
6. Page 4-5 - the authors need to emphasize why there study is an important
contribution to the literature that is not present in the studies described
7. Methods - search terminology? Could the search terminology have
underestimated either Celiac or EoE cases
8. Methods - again appears to be hisologic esophageal eosinophilia vs EoE by
current criteria
9. Page 9 - given that there were only 3 subjects identified, I wonder about
contacting these patients
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I do not have any competing interests that are relevant to the review of this
manuscript
Reviewer's report
Title:The Association Between Celiac Disease and Eosinophilic Esophagitis in
Children and Adults
Version: 1Date:18 March 2013
Reviewer: James Franciosi
Reviewer's report:
The authors present an interesting manuscript reporting a population-based
study investigating the incidence rates of Celiac Disease and EoE (really,
esophageal eosinophilia). Overall the manuscript is well written and statistically
sound. I submit the following Major Compulsory Revisions
1. In the first paragraph, the authors report that the incidence of EoE has risen
dramatically over the past decade, yet the data in table 1 do not show this to be
the case at least for the pediatric subpopulation.
2. The inclusion of both Table 1 and Figure 1 appear redudant. Figures do not
have Titles provided
3. The authors need to explore further the difference in IR in total vs pediatric
cohorts- have the adult biopsy practices changed in their adult groups that may
explain these apparent rises as ascertainment bias?
DeBrosse, C.W., Collins, M.H., Buckmeier Butz, B.K., Allen, C.L., King, E.C.,
Assa'ad, A.H., Abonia, J.P., Putnam, P.E., Rothenberg, M.E., Franciosi, JP.
Identification, epidemiology, and chronicity of pediatric esophageal eosinophilia,
1982-1999. J Allergy Clin Immunol. 2010 Jul;125 (1):112-9
4. The current EoE consensus guidelines (Liacouras, JACI, 2011) note Celiac
Disease as associated with Esophageal Eosinophilia as distinct from EoE. This
combined with the relatively unknown clinical criteria for EoE in the 3 subjects,
really suggest that these subjects are best termed as having esophageal
eosinophilia. Certainly a controversial topic, but one could argue that PPI
responsive esophageal eosinophilia has not been excluded, and Esophageal
eosinophilia in the context of duodenitis does not meet the defintions for EoE
5. Table 2 - what happened to the esophageal eosinophilia when wheat was
eliminated and the duodenitis resolved on repeat endoscopy?
6. Page 4-5 - the authors need to emphasize why there study is an important
contribution to the literature that is not present in the studies described
7. Methods - search terminology? Could the search terminology have
underestimated either Celiac or EoE cases
8. Methods - again appears to be hisologic esophageal eosinophilia vs EoE by
current criteria
9. Page 9 - given that there were only 3 subjects identified, I wonder about
contacting these patients
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I do not have any competing interests that are relevant to the review of this
manuscript
Please review this paper.
user
Reviewer's report
Title:The Association Between Celiac Disease and Eosinophilic Esophagitis in
Children and Adults
Version: 1Date:18 March 2013
Reviewer: James Franciosi
Reviewer's report:
The authors present an interesting manuscript reporting a population-based
study investigating the incidence rates of Celiac Disease and EoE (really,
esophageal eosinophilia). Overall the manuscript is well written and statistically
sound. I submit the following Major Compulsory Revisions
1. In the first paragraph, the authors report that the incidence of EoE has risen
dramatically over the past decade, yet the data in table 1 do not show this to be
the case at least for the pediatric subpopulation.
2. The inclusion of both Table 1 and Figure 1 appear redudant. Figures do not
have Titles provided
3. The authors need to explore further the difference in IR in total vs pediatric
cohorts- have the adult biopsy practices changed in their adult groups that may
explain these apparent rises as ascertainment bias?
DeBrosse, C.W., Collins, M.H., Buckmeier Butz, B.K., Allen, C.L., King, E.C.,
Assa'ad, A.H., Abonia, J.P., Putnam, P.E., Rothenberg, M.E., Franciosi, JP.
Identification, epidemiology, and chronicity of pediatric esophageal eosinophilia,
1982-1999. J Allergy Clin Immunol. 2010 Jul;125 (1):112-9
4. The current EoE consensus guidelines (Liacouras, JACI, 2011) note Celiac
Disease as associated with Esophageal Eosinophilia as distinct from EoE. This
combined with the relatively unknown clinical criteria for EoE in the 3 subjects,
really suggest that these subjects are best termed as having esophageal
eosinophilia. Certainly a controversial topic, but one could argue that PPI
responsive esophageal eosinophilia has not been excluded, and Esophageal
eosinophilia in the context of duodenitis does not meet the defintions for EoE
5. Table 2 - what happened to the esophageal eosinophilia when wheat was
eliminated and the duodenitis resolved on repeat endoscopy?
6. Page 4-5 - the authors need to emphasize why there study is an important
contribution to the literature that is not present in the studies described
7. Methods - search terminology? Could the search terminology have
underestimated either Celiac or EoE cases
8. Methods - again appears to be hisologic esophageal eosinophilia vs EoE by
current criteria
9. Page 9 - given that there were only 3 subjects identified, I wonder about
contacting these patients
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I do not have any competing interests that are relevant to the review of this
manuscript
assistant