title: Mucosal eosinophilia: prevalence and racial/ethnic differences in symptoms and endoscopic findings in adults over 10 years in an urban hospital.
abstract: BACKGROUND
  Eosinophilic esophagitis is a chronic inflammatory disease with mucosal accumulation of eosinophils. There is a paucity of data among racial/ethnic groups other than white patients.
  
  
  OBJECTIVE
  To determine if racial/ethnic differences exist in clinical presentation, endoscopic appearance, and biopsy results in adult patients (age ≥18 y) with mucosal eosinophilia and examine the prevalence of mucosal eosinophilia at an urban hospital over a 10-year period.
  
  
  METHODS
  Pathology reports searched at Temple University Hospital 2000 to 2009; key words: "eosinophils", "esophagus", and "biopsy". Clinical and endoscopic records reviewed on patients with ≥15 eosinophils/high power field.
  
  
  RESULTS
  A total of 64 adults (average age, 41 y; 62% male patients; 81% white, 12% black, and 6% Hispanic). White patients were significantly younger (P=0.03). Adult mucosal eosinophilia diagnosis increased by 833% (3 in 2000 to 25 in 2009); black/Hispanic diagnosis increased by 500% (1 in 2000 to 5 in 2009). Solid food dysphagia was more common among white patients (72% vs. 0.33%, P=0.02). Reflux symptoms were more common in black/Hispanic patients (42% vs. 22%, P=0.16). Normal endoscopy (42% vs. 13%, P=0.04) and reflux changes (41% vs. 21%, P=0.16) were more common in black/Hispanic patients. Furrows (42% vs. 8%, P=0.04) and rings (46% vs. 0%, P=0.002) were more common in white patients. Average eosinophil counts did not vary between groups.
  
  
  CONCLUSIONS
  Mucosal eosinophilia presents with significant differences between racial/ethnic groups in age at onset, symptoms at presentation, and endoscopic features. Differences may reflect different phenotypes of the same disease or separate disease entities.
authors.affiliation: Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bohm
authors.forename: Zubair
authors.initials: Z
authors.lastname: Malik
authors.forename: Christopher
authors.initials: C
authors.lastname: Sebastiano
authors.forename: Rebecca
authors.initials: R
authors.lastname: Thomas
authors.forename: John
authors.initials: J
authors.lastname: Gaughan
authors.forename: Steven
authors.initials: S
authors.lastname: Kelsen
authors.forename: Joel E
authors.initials: JE
authors.lastname: Richter
mesh_terms: D000328:Adult; D017668:Age of Onset; D044383:Black People; D003237:Connecticut / Q000453:epidemiology; D004802:Eosinophilia / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D004941:Esophagitis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D004945:Esophagoscopy; D005260:Female; D006630:Hispanic or Latino; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008873:Mid-Atlantic Region / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D044465:White People; D001741:Black or African American