TY - JOUR
T1 - Racial Differences in the Clinical Presentation of Pediatric Eosinophilic Esophagitis
AU - Weiler, Thomas
AU - Mikhail, Irene
AU - Singal, Amit
AU - Sharma, Hemant
PY - 2014/5
Y1 - 2014/5
N2 - Background: Analysis of current data suggests that 80% to 90% of children diagnosed with eosinophilic esophagitis are white. Little data exist regarding the presentation of eosinophilic esophagitis and potential clinical differences in minority children. Objective: This study compared the clinical presentation of eosinophilic esophagitis in African American children with white children treated at an urban allergy referral center. Methods: At an urban allergy clinic, a 2-year retrospective chart review was performed of 50 consecutive pediatric patients diagnosed with eosinophilic esophagitis. Presenting symptoms, age at diagnosis, coexisting atopic disease, and laboratory parameters were compared between races. Results: Most of the 50 children identified were boys (74%), as previously described. However, unlike prior literature, most were nonwhite (42% white, 42% African American, 4% Asian, and 12% other). African American children compared with white children had (1) a significantly higher frequency of failure to thrive (. P < .01) and vomiting (. P < .01) as presenting symptoms, (2) a higher frequency of comorbid atopic dermatitis (. P < .01), (3) a younger mean age of symptom presentation and formal diagnosis (3.7 vs 9.1 years; P < .01), and (4) a trend toward a longer interval between symptom onset and formal diagnosis. However, after adjusting for confounding variables of age and insurance type, several of these racial differences were no longer significant. Conclusion: African American children in this series had a larger burden of eosinophilic esophagitis than previously described as well as differences in clinical presentation compared with white patients. Analysis of these findings suggests that providers be aware of this potential diagnosis in young, atopic African American children with symptoms of esophageal dysfunction.
AB - Background: Analysis of current data suggests that 80% to 90% of children diagnosed with eosinophilic esophagitis are white. Little data exist regarding the presentation of eosinophilic esophagitis and potential clinical differences in minority children. Objective: This study compared the clinical presentation of eosinophilic esophagitis in African American children with white children treated at an urban allergy referral center. Methods: At an urban allergy clinic, a 2-year retrospective chart review was performed of 50 consecutive pediatric patients diagnosed with eosinophilic esophagitis. Presenting symptoms, age at diagnosis, coexisting atopic disease, and laboratory parameters were compared between races. Results: Most of the 50 children identified were boys (74%), as previously described. However, unlike prior literature, most were nonwhite (42% white, 42% African American, 4% Asian, and 12% other). African American children compared with white children had (1) a significantly higher frequency of failure to thrive (. P < .01) and vomiting (. P < .01) as presenting symptoms, (2) a higher frequency of comorbid atopic dermatitis (. P < .01), (3) a younger mean age of symptom presentation and formal diagnosis (3.7 vs 9.1 years; P < .01), and (4) a trend toward a longer interval between symptom onset and formal diagnosis. However, after adjusting for confounding variables of age and insurance type, several of these racial differences were no longer significant. Conclusion: African American children in this series had a larger burden of eosinophilic esophagitis than previously described as well as differences in clinical presentation compared with white patients. Analysis of these findings suggests that providers be aware of this potential diagnosis in young, atopic African American children with symptoms of esophageal dysfunction.
KW - African American
KW - Eosinophilic esophagitis
KW - Health disparities
KW - Race
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U2 - 10.1016/j.jaip.2014.01.011
DO - 10.1016/j.jaip.2014.01.011
M3 - Article
C2 - 24811024
AN - SCOPUS:84899913581
SN - 2213-2198
VL - 2
SP - 320
EP - 325
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 3
ER -