Mo1152 – Validation of a Model to Predict Complete Histologic Response to Topical Steroids in Adult Patients with Eosinophilic Esophagitis

examined.Aim: To determine whether psychiatric comorbidities are associated with clinical characteristics and disease activity at the time of EoE diagnosis.Methods: We conducted a retrospective cohort study utilizing the UNC EoE Clinicopathologic Database to identify all EoE patients with a psychiatric comorbidity treated at UNC Hospital between 2002 and 2018.This database contains data extracted from electronic medical records including: patient demographics, symptoms, endoscopic findings, and histologic features.We focused on the association between the presence of a psychiatric comorbidity and symptom reporting, individual endoscopic findings, and histology (peak eosinophil count per high-power field [eos/hpf]) at the time of initial diagnosis.We compared EoE patients with and without psychiatric diagnoses, and then used multivariate regression models to assess the relationship between presence of a psychiatric diagnosis and clinical features adjusted for covariates including gender, race, age at EoE diagnosis, atopic disease diagnosis, and baseline eosinophil count.Results: Of 883 EoE cases included in this study, 220 were clinically diagnosed with a psychiatric comorbidity.Compared to those without a psychiatric diagnosis, EoE cases with a psychiatric diagnosis were more likely to be female, white, ≥ 18 years old, and with a longer symptom duration prior to diagnosis (Table 1).They were also more likely to report symptoms of heartburn [OR 1.61 (95% CI: 1.14 -2.27)], but not dysphagia or chest pain (Table 2).Patients with and without a psychiatric comorbidity had similar endoscopic findings, including stricture (24% vs 23%; p=0.77) and need for esophageal dilation (27% vs 23%; p=0.17) (Table 2).Though statistically significant, baseline eosinophil counts were also of the same order of magnitude (61.0 vs. 68.6 eos/hpf; p=0.02).Conclusions EoE patients with psychiatric comorbidities are more likely to be older, female, white, report heartburn, and have a longer duration of symptoms.However, endoscopic findings and eosinophil counts did not differ by presence of a psychiatric comorbidity.This study provides the initial evidence that psychiatric illness may affect the presentation of EoE.