Background

Manifestations of pediatric eosinophilic esophagitis (EoE) are varied and dictated by multiple factors. The influence of race is limited to small observational cohorts of dichotomized data (Whites vs non-Whites) or single-racial analysis.

Objective

To better understand phenotypic variability in the manifestation and atopic sensitization of pediatric EoE, from the perspective of race.

Methods

Retrospective observational cohort study performed at a tertiary referral center. Subjects were included if less than 21 years old, with suggestive clinical features and histopathologic (>15 eosinophils/high-power field [hpf]) confirmation of EoE. Statistical computation was performed using Stata/IC 11 on variables of interest.

Results

A total of 34 subjects were included in the analysis. The median (interquartile range [IQR]) age for initial atopy was 2 (1-5) years. The median (IQR) age for EoE diagnosis was 5 (3-8) years. Age of EoE diagnosis was higher for Black or African Americans than non-Black or African Americans (P = .01). Between the racial groups, there was no difference in the total number of food sensitizations (P = .13), yet environmental allergy testing revealed that Black or African Americans were more likely to be sensitized for weeds (P = .03), dog (P = .009), and mold (P = .006). On histopathologic analysis, Black or African American subjects were found to have more prominent midesophageal eosinophilia at median 50/hpf (20-80/hpf), whereas Hispanic or LatinXs have more prominent lower esophageal eosinophilia at median 40/hpf (IQR, 20-40/hpf), compared with the other races (P = .04 and P = .04, respectively).

Conclusion

Black or African Americans are more likely to present at an older age, have aeroallergen sensitization, and have more prominent midesophageal eosinophilia.

中文翻译：

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城市内城区诊所小儿嗜酸性粒细胞性食管炎的种族特异性特征

背景

小儿嗜酸性粒细胞性食管炎 (EoE) 的表现多种多样，受多种因素影响。种族的影响仅限于二分数据（白人与非白人）或单一种族分析的小型观察队列。

客观的

从种族的角度更好地了解儿科 EoE 表现和特应性致敏的表型变异性。

方法

在三级转诊中心进行的回顾性观察队列研究。如果年龄小于 21 岁、具有提示性临床特征和组织病理学（>15 个嗜酸性粒细胞/高倍视野 [hpf]）证实 EoE，则纳入受试者。使用 Stata/IC 11 对感兴趣的变量进行统计计算。

结果

共有 34 名受试者被纳入分析。初始特应性的中位（四分位距 [IQR]）年龄为 2 (1-5) 岁。EoE 诊断的中位 (IQR) 年龄为 5 (3-8) 岁。黑人或非裔美国人的 EoE 诊断年龄高于非黑人或非裔美国人 ( P  = .01)。在种族群体之间，食物致敏总数没​​有差异 ( P  = .13)，但环境过敏测试显示黑人或非裔美国人更容易对杂草 ( P  = .03)、狗 ( P  = .009) 和模具 ( P = .006）。在组织病理学分析中，发现黑人或非裔美国人受试者在中位数为 50/hpf (20-80/hpf) 时具有更突出的食管中嗜酸性粒细胞增多，而西班牙裔或拉丁裔在中位数为 40/hpf (IQR，20- 40/hpf），与其他种族相比（分别为P  = .04 和P  = .04）。

结论

黑人或非裔美国人更有可能在老年时出现，有空气过敏原致敏，并且有更突出的中食管嗜酸性粒细胞增多症。