title: Influence of race and gender on the presentation of eosinophilic esophagitis.
abstract: OBJECTIVE
  Eosinophilic esophagitis (EoE) is thought to be more common among males and Caucasians, but little is known about the disease presentation among patients with different genders or racial backgrounds. The objective of this study was to determine the clinical, endoscopic, and histologic characteristics of patients with EoE of different genders or racial backgrounds.
  
  
  METHODS
  We conducted a retrospective study of the University of North Carolina EoE clinicopathologic database between January 2000 and December 2008. Cases of EoE were defined per 2007 consensus guidelines and stratified by race and gender for comparison.
  
  
  RESULTS
  In all, 208 incident EoE cases were identified (76% males, mean age 26 years, 82% Caucasian, and 12% African American). Caucasians were older at diagnosis than African Americans (27.1 vs. 19.0 years, P=0.05), less likely to present with failure-to-thrive (9 vs. 30%, P=0.002), and more likely to have esophageal rings (41 vs. 12%, P=0.005). These findings persisted after stratification by age. A higher proportion of males were diagnosed under the age of 18 as compared with females (48 vs. 64%, P=0.05). Males were more likely to report dysphagia and food impaction as symptoms (71 vs. 53%, P=0.02 and 35 vs. 20%, P=0.05, respectively), and these findings also persisted after stratification by age. The remainder of clinical, endoscopic, and histologic features did not differ by either race or gender.
  
  
  CONCLUSIONS
  While age and dysphagia differed by gender and race among EoE patients, the majority of symptoms and findings were not different across groups, even after stratification by age. Clinicians should maintain a high index of suspicion for EoE, regardless of race or gender, and obtain esophageal biopsies to confirm the diagnosis.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7080, USA.
authors.forename: Sarah Lw
authors.initials: SL
authors.lastname: Sperry
authors.forename: John T
authors.initials: JT
authors.lastname: Woosley
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Shaheen
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000175:diagnosis; D057765:Eosinophilic Esophagitis / Q000175:diagnosis*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D044465:White People