Effects of Race and Sex on Features of Eosinophilic Esophagitis.
OBJECTIVE
Clinical and endoscopic features of eosinophilic esophagitis (EoE) differ between children and adults and among racial backgrounds. We investigated whether there were any associations between race or sex and clinical presentation, endoscopic features, and histologic findings from patients with EoE of various racial backgrounds.


METHODS
We performed a retrospective, multicenter, cross-sectional analysis of 793 patients with EoE (476 adults and 317 children; mean age, 26 years; range, 0.1-84 years; 72% male) from clinical registries at 5 tertiary care centers in the United States. EoE was defined per consensus guidelines. Data with predetermined variables were extracted from clinical registries at each participating institution.


RESULTS
Of the study cohort, 660 patients were white (83%), 77 were African American (10%), and 56 were of other races (7%). A significantly larger proportion of white persons than African Americans or other races had dysphagia (74%, 56%, and 53%, respectively; P < .001), food impaction (35%, 13%, and 13%, respectively; P < .001), and features of EoE that included rings (46%, 25%, and 18%, respectively; P < .001) or furrows (70%, 58%, and 55%, respectively; P = .012). Males and females had similar clinical presentations, histories of atopy, findings from endoscopy, and histologic characteristics. A higher proportion of males than females had strictures (17% vs 11%; P = .038).


CONCLUSIONS
Race, and to a smaller degree sex, are associated with features of EoE. African Americans have different clinical symptoms and fewer endoscopic features of EoE than white persons. EoE should be considered in African Americans even without typical findings.
Gastroenterology Service, Walter Reed National Military Medical Center, Bethesda, Maryland. Electronic address: Fouad.Moawad@us.army.mil.
Fouad J
FJ
Moawad
Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Evan S
ES
Dellon
Department of Gastroenterology, Mayo Clinic, Jacksonville, Florida.
Sami R
SR
Achem
Division of Gastroenterology, Indiana University, Bloomington, Indiana.
Tony
T
Ljuldjuraj
Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Daniel J
DJ
Green
Gastroenterology Service, Walter Reed National Military Medical Center, Bethesda, Maryland.
Corinne L
CL
Maydonovitch
Department of Gastroenterology, Mayo Clinic, Jacksonville, Florida.
Diana R
DR
Brizuela
Division of Gastroenterology, Indiana University, Bloomington, Indiana.
Sandeep K
SK
Gupta
Departments of Pediatrics and Medicine, Mount Sinai Center for Eosinophilic Disorders, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
Mirna
M
Chehade
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D057765:Eosinophilic Esophagitis / Q000453:epidemiology / Q000473:pathology*; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Allergy; Eosinophilic Esophagitis; Epidemiology; Food; Race