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Wilson BE, Wright BL, Swing T, Schroeder S, Bauer CS. Eosinophilic esophagitis in Native American children and young adults: A case control study. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00482-4. [PMID: 39069153 DOI: 10.1016/j.anai.2024.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Affiliation(s)
- Bridget E Wilson
- Division of Allergy and Immunology, Phoenix Children's, Phoenix, Arizona; Division of Allergy, Asthma, and Clinical Immunology, Department of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona.
| | - Benjamin L Wright
- Division of Allergy and Immunology, Phoenix Children's, Phoenix, Arizona; Division of Allergy, Asthma, and Clinical Immunology, Department of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Ted Swing
- Department of Graduate Medical Education, Phoenix Children's, Phoenix, Arizona
| | - Shauna Schroeder
- Department of Gastroenterology, Phoenix Children's, Phoenix, Arizona; Department of Child Health, University of Arizona College of Medicine, Phoenix, Arizona
| | - Cindy S Bauer
- Division of Allergy and Immunology, Phoenix Children's, Phoenix, Arizona; Department of Child Health, University of Arizona College of Medicine, Phoenix, Arizona
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Lendner N, Minich NM, Malay S, Sferra TJ, Young DD. Comparison of budesonide vehicles in inducing histologic remission in pediatric eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2024; 79:92-99. [PMID: 38803200 DOI: 10.1002/jpn3.12273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/27/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES Oral viscous budesonide (OVB) is a common medication used to treat eosinophilic esophagitis (EoE). It is typically mixed with Splenda to produce a slurry, but other delivery vehicles have been used in clinical practice. We aimed to evaluate outcomes of pediatric EoE patients treated with OVB using different drug delivery vehicles. METHODS We performed a retrospective chart review of pediatric EoE patients treated with OVB. The primary aim was to evaluate rates of histologic remission (defined by <15 eosinophils per high power field in both mid and distal esophagus) after 6-12 weeks of OVB treatment for each delivery vehicle. Secondary aims were to evaluate histologic response and endoscopic response and remission of different delivery vehicles, and to compare the efficacy of different treatment regimens. RESULTS A total of 111 patients were included in the study. Median treatment duration was 3.4 months. Overall rate of histologic remission with OVB was 52.6%. There was no difference in rates of histologic remission (p = 0.313) or response (p = 0.195 and p = 0.681 in mid and distal esophagus, respectively) among the different vehicle types or treatment regimens. Similarly, there was no difference in endoscopic remission and response among the different vehicle types (p = 0.853 and p = 0.727) or treatment regimens (p = 0.244 and p = 0.157). Patients who achieve histologic remission were more likely to be non-Hispanic Caucasian. CONCLUSION Our findings suggest there is no difference in histologic and endoscopic outcomes with various delivery vehicles or combination therapy with OVB in the treatment of EoE. More palatable and cost-effective vehicles can be used to treat EoE.
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Affiliation(s)
- Nuphar Lendner
- Pediatrix Gastroenterology of the Rocky Mountains, Denver, Colorado, USA
| | - Nori Mercuri Minich
- Biostastics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Sindhoosha Malay
- Biostastics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Thomas J Sferra
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Denise D Young
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
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Ocampo AA, Xue Z, Chang NC, Thakkar KP, Reddy SB, Greenberg SB, Lee CJ, Ketchem CJ, Redd WD, Eluri S, Reed CC, Dellon ES. Clinical Features and Treatment Response to Topical Steroids in Ethnic and Racial Minority Patients With Eosinophilic Esophagitis. Am J Gastroenterol 2024; 119:262-269. [PMID: 37782465 PMCID: PMC10872844 DOI: 10.14309/ajg.0000000000002532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/05/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION Differences in eosinophilic esophagitis (EoE) presentation and outcomes by ethnicity or race remain understudied. We aimed to determine whether EoE patients of Hispanic/Latinx ethnicity or non-White race have differences in presentation at diagnosis or response to topical corticosteroid (tCS) treatment. METHODS This retrospective cohort study included subjects of any age with a new diagnosis of EoE and documentation of ethnicity or race. For those who had treatment with tCS and follow-up endoscopy/biopsy, we assessed histologic response (<15 eosinophils/hpf), global symptom response, and endoscopic response. Hispanic EoE patients were compared with non-Hispanics at baseline and before and after treatment. The same analyses were repeated for White vs non-Whites. RESULTS Of 1,026 EoE patients with ethnicity data, just 23 (2%) were Hispanic. Most clinical features at presentation were similar to non-Hispanic EoE patients but histologic response to tCS was numerically lower (38% vs 57%). Non-White EoE patients (13%) were younger at diagnosis and had less insurance, lower zip code-level income, shorter symptom duration, more vomiting, less dysphagia and food impaction, fewer typical endoscopic features, and less dilation. Of 475 patients with race data treated with tCS, non-Whites had a significantly lower histologic response rate (41% vs 59%; P = 0.01), and odds of histologic response remained lower after controlling for potential confounders (adjusted odds ratio 0.40, 95% confidence intervals: 0.19-0.87). DISCUSSION Few EoE patients at our center were Hispanic, and they had similar clinical presentations as non-Hispanics. The non-White EoE group was larger, and presentation was less dysphagia-specific. Non-White patients were also less than half as likely to respond to tCS.
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Affiliation(s)
- Adolfo A. Ocampo
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Zeyun Xue
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Nicole C. Chang
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Kisan P. Thakkar
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Sumana B. Reddy
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Sydney B. Greenberg
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Christopher J. Lee
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Corey J. Ketchem
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Walker D. Redd
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Swathi Eluri
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Craig C. Reed
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Evan S. Dellon
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
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Hiremath G, Yazdian A, Onuh I, Willey J, Choksi Y. Race and Gender Influences the Presentation of Eosinophilic Esophagitis. Dysphagia 2023; 38:1511-1518. [PMID: 37069435 PMCID: PMC10579448 DOI: 10.1007/s00455-023-10577-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 04/07/2023] [Indexed: 04/19/2023]
Abstract
Our understanding of the influence of race and gender on the presentation of eosinophilic esophagitis (EoE) is incomplete. To address this gap, we examined the effect of race and gender on the presentation of EoE. In this retrospective study, we reviewed the medical records of 755 EoE patients and recorded their demographic, clinical, endoscopic, and histologic information. Descriptive statistics were used to characterize the cohort. Multivariate logistic regression was used to identify predictors of race and gender after accounting for potential confounders. There was a bimodal distribution for age at diagnosis of EoE. Approximately 43% had pediatric onset EoE, while 57% had adult onset EoE. Male (68%) predominance was observed. Dysphagia (57%) and abdominal pain (20%) were among the most common presenting symptoms. Multivariate analysis revealed that African Americans (AAs) were diagnosed earlier [aOR: 0.96 (95% CI: 0.95-0.99); P = 0.01] and had significantly lower odds of manifesting furrows [aOR: 0.30 (95% CI: 0.12-0.77); P = 0.01] as compared with Whites. Males were diagnosed earlier [aOR 0.98 (0.97-0.99; P = 0.04] and had higher odds of having abnormal endoscopic findings [aOR: 1.43 (1.05-1.97); P = 0.02] when compared with females. Race and gender influence the presentation of EoE. Future studies aimed at investigating the interplay between race, gender, and molecular mechanisms of EoE are warranted.
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Affiliation(s)
- Girish Hiremath
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, DOT 11226, 2200, Children's Way, Nashville, TN, 37232-5280, USA.
| | - Aaron Yazdian
- Department of Internal Medicine, Temple University, Philadelphia, PA, USA
| | - Ifeanyi Onuh
- Division of Adult Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jade Willey
- Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Yash Choksi
- Division of Adult Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
- Tennessee Valley Health System, Veterans Affairs, Nashville, TN, USA
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Koenigsberg R, Gupta S, Slaven JE, Sarin T, Vitalpur G. Body mass index in relation to symptom presentation on diagnosis of eosinophilic esophagitis in children. Ann Allergy Asthma Immunol 2023; 131:482-486. [PMID: 37311509 DOI: 10.1016/j.anai.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND The relationship between body mass index (BMI) and eosinophilic esophagitis (EoE) among children is not well characterized. OBJECTIVE To evaluate the presentations of EoE in pediatric patients of different weight classes. METHODS Records of newly diagnosed children with EoE at an academic center from 2015 to 2018 were evaluated regarding demographics, symptom presentation, and endoscopic findings and compared among the underweight, normal weight, overweight, and obese groups. RESULTS There were 341 patients aged 0 to 18 years old newly diagnosed with EoE from 2015 to 2018 (68.3% male, 233 of 341; 80.9% White, 276 of 341). Of the 341, 17 were underweight (4.9%), 214 normal weight (62.8%), 47 overweight (13.8%), and 63 obese (18.5%). Children with obese and overweight BMI were more likely to be diagnosed at an older age (P = .005) and to present with a chief complaint of abdominal pain (P = .02). Normal- and under-weight children were more likely to have an immunoglobulin E-mediated food allergy (P = .02). Normal weight children were more likely to be tested for food allergies (P = .02) and inhalant allergies (P = .004) and have linear furrows on endoscopy (P = .03), compared with children with overweight and obese BMI. No significant differences were found regarding race, sex, type of insurance, atopic dermatitis, asthma, or allergic rhinitis in relation to BMI status and EoE diagnosis. CONCLUSION Nearly one-third of children were obese or in overweight status on diagnosis with EoE. Children with BMI in the overweight or obese range were more likely to be older at diagnosis and to have a chief complaint of abdominal pain on presentation.
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Affiliation(s)
- Rebecca Koenigsberg
- Division of Allergy & Immunology, Nationwide Children's Hospital and the Ohio State University College of Medicine, Columbus, Ohio
| | - Sandeep Gupta
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, University of Alabama at Birmingham, Birmingham, Alabama
| | - James E Slaven
- Department of Biostatistics and Public Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Tara Sarin
- Allergy Associates of Utah, Murray, Utah
| | - Girish Vitalpur
- Division of Pediatric Pulmonology, Allergy-Immunology & Sleep Medicine, Riley Hospital for Children at Indiana University Health and the Indiana University School of Medicine, Indianapolis, Indiana.
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Redd WD, Ocampo AA, Xue Z, Chang NC, Thakkar KP, Reddy SB, Greenberg SB, Lee CJ, Ketchem CJ, Eluri S, Reed CC, Dellon ES. Eosinophilic esophagitis patients with multiple atopic conditions: Clinical characteristics and treatment response to topical steroids. Ann Allergy Asthma Immunol 2023; 131:109-115.e2. [PMID: 37100277 PMCID: PMC10330289 DOI: 10.1016/j.anai.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Patients with eosinophilic esophagitis (EoE) typically have concomitant atopic conditions, but whether there are differences in presentation or treatment response by the number of atopic diseases is unknown. OBJECTIVE To determine whether patients with EoE having multiple atopic conditions have differences in presentation or response to topical corticosteroid (TCS) treatment. METHODS We performed a retrospective cohort study of adults and children with newly diagnosed EoE. The total number of atopic comorbidities (allergic rhinitis, asthma, eczema, food allergy) was calculated. Patients with at least 2 atopic conditions other than allergic rhinitis were defined as having multiple atopic conditions and their baseline characteristics were compared with those with less than 2 atopic conditions. Histologic, symptom, and endoscopic responses to TCS treatment were also compared with bivariable and multivariable analyses. RESULTS Of the 1020 patients with EoE having atopic disease information, 235 (23%) had 1 atopic comorbidity, 211 (21%) had 2, 113 (11%) had 3, and 34 (3%) had 4. At baseline, the 180 (18%) patients with 2 or more atopic diseases were younger and had more vomiting, less abdominal pain, more exudates and edema on endoscopy, and higher peak eosinophil counts. Among those treated with TCS, there was a trend toward better global symptom response in patients with less than 2 atopic conditions, but there was no difference in histologic or endoscopic response compared with those with 2 or more atopic conditions. CONCLUSION There were differences in the initial presentation of EoE between those with and without multiple atopic conditions, but there were no major differences in histologic treatment response to corticosteroids by atopic status.
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Affiliation(s)
- Walker D Redd
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Adolfo A Ocampo
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Zeyun Xue
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Nicole C Chang
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Kisan P Thakkar
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Sumana B Reddy
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Sydney B Greenberg
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Christopher J Lee
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Corey J Ketchem
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Swathi Eluri
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Craig C Reed
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Evan S Dellon
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
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Jafri S, Janzen J, Kim R, Abrams EM, Gruber J, Protudjer JLP. Burden of Allergic Disease in Racial and Ethnic Structurally Oppressed Communities Within Canada and the United States: A Scoping Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2995-3001. [PMID: 35995399 DOI: 10.1016/j.jaip.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The social determinants of health have been extensively studied as potential mediating variables in the development and/or progression of many chronic illnesses, including allergic diseases, and may contribute to social inequities as barriers in accessing health care. OBJECTIVE We aimed to perform a scoping literature review to describe the burden of disease and access to health care for treatment of allergic disease within literature specific to structurally oppressed racial and ethnic populations. METHODS We performed a scoping review, guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines for Scoping Reviews, of 3 scientific databases and 5 relevant gray literature sites. Search strategy including keywords describing race and ethnicity were selected based on the acceptable nomenclature in Canada and the United States. We imposed no restrictions on date or country of publication, study design, or age of participants. RESULTS Our literature search yielded 1,198 potentially relevant articles following deduplication. After title and abstract, and subsequently full-text screening, a total of 12 (1.08% of all articles) were included. These 12 included studies pointed toward a higher burden of allergic and atopic disease, including increased presentations to emergency departments, hospitalizations, mortality, younger age of diagnosis, and/or greater severity of disease, among Black or African American individuals, than the general population. Allergies beyond the top 9 food allergens, eosinophilic esophagitis, and asthma appeared to be more prevalent and more severe in this population than in the general population. There appears to be an increased burden of allergic and atopic disease among the Indigenous Peoples of Canada, whereas this was not noted for Latinx or Hispanic populations, in part due to a paucity of studies involving these populations. Owing to a lack of published literature, no conclusions could be drawn regarding allergy and atopy in Native American populations. CONCLUSIONS Structurally oppressed racial and ethnic communities may face an increased burden of allergic and atopic disease-but that this may be magnified by issues regarding oppression, access, and social environment that warrant further investigation.
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Affiliation(s)
- Syeda Jafri
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jacob Janzen
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rebecca Kim
- Department of Biomedical and Molecular Science, Faculty of Arts and Science, Queen's University, Kingston, Ontario, Canada
| | - Elissa M Abrams
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Jackie Gruber
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; British Columbia Institute of Technology, Burnaby, British Columbia, Canada
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
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Edwards-Salmon S, Moraczewski J, Offerle T, Sinclair EM, Xiang Y, Gillespie S, Kruszewski P. Comparing Eosinophilic Esophagitis in a Black and Non-Black Pediatric Cohort. J Pediatr Gastroenterol Nutr 2022; 75:485-490. [PMID: 35797567 DOI: 10.1097/mpg.0000000000003552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES To compare presenting symptoms, comorbidities, disease, and treatment characteristics of a black pediatric eosinophilic esophagitis (EoE) group to a non-black pediatric EoE group. METHODS A retrospective chart review consisting of pediatric patients diagnosed with EoE between the years of 2010 and 2018 at a single urban pediatric hospital system comprising 143 black pediatric patients compared with 142 non-black pediatric patients with similar distribution of age and sex. RESULTS Both groups were majority male, and the median age of diagnosis between the black and non-black group was 5.1 and 6.7 years old, respectively. Comorbidities more commonly seen in the black group included food allergies, atopic dermatitis, asthma, and allergic rhinitis. Black patients were more likely to present with failure to thrive (FTT)/poor growth, whereas non-black patients were more likely to present with abdominal pain. There was no statistically significant difference between the groups in achieving remission using current therapies. The black group had higher rates of nonadherence to medical therapies. CONCLUSIONS This is the largest study to date comparing a black versus non-black pediatric EoE population. The black population had more atopic comorbidities and FTT at presentation and had significantly more issues with nonadherence. This new knowledge describing EoE in a minority population will hopefully improve awareness, diagnosis, and management of EoE in this population.
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Affiliation(s)
- Sofia Edwards-Salmon
- From the Emory School of Medicine, Atlanta, GA
- the Section of Allergy & Immunology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA
| | | | | | - Elizabeth M Sinclair
- the Department of Pediatric Gastroenterology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Yijin Xiang
- From the Emory School of Medicine, Atlanta, GA
- the Children's Healthcare of Atlanta, Atlanta, GA
| | - Scott Gillespie
- From the Emory School of Medicine, Atlanta, GA
- the Children's Healthcare of Atlanta, Atlanta, GA
| | - Patrice Kruszewski
- the Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA
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