title: Racial differences in the clinical presentation of pediatric eosinophilic esophagitis.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Allergy and Immunology, Children's National Medical Center, Washington, DC.
authors.forename: Thomas
authors.initials: T
authors.lastname: Weiler
authors.affiliation: Division of Allergy and Immunology, Children's National Medical Center, Washington, DC.
authors.forename: Irene
authors.initials: I
authors.lastname: Mikhail
authors.affiliation: Division of Allergy and Immunology, Children's National Medical Center, Washington, DC.
authors.forename: Amit
authors.initials: A
authors.lastname: Singal
authors.affiliation: Division of Allergy and Immunology, Children's National Medical Center, Washington, DC. Electronic address: hsharma@childrensnational.org.
authors.forename: Hemant
authors.initials: H
authors.lastname: Sharma
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D017668:Age of Onset; D002675:Child, Preschool; D015897:Comorbidity; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000276:immunology; D004219:District of Columbia / Q000453:epidemiology; D057765:Eosinophilic Esophagitis / Q000453:epidemiology* / Q000276:immunology; D005183:Failure to Thrive / Q000453:epidemiology / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000379:methods; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017678:Sex Distribution; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data
keywords: African American; Eosinophilic esophagitis; Health disparities; Race