ABSTRACT
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.
Subject(s)
Eosinophilic Esophagitis/ethnology , Allergens/immunology , Ambulatory Care Facilities , Biopsy , Child , Child, Preschool , Cities , Eosinophilic Esophagitis/blood , Eosinophilic Esophagitis/immunology , Eosinophils/immunology , Esophagus/immunology , Esophagus/pathology , Female , Hospitals, Urban , Humans , Immunoglobulin E/blood , Male , Racial Groups , Retrospective StudiesSubject(s)
Bezoars/therapy , Carbonated Beverages , Stomach/injuries , Child, Preschool , Female , Humans , Treatment OutcomeSubject(s)
Hepacivirus , Hepatitis C/diagnosis , Hepatitis, Autoimmune/diagnosis , Alanine Transaminase/blood , Antibodies, Viral/blood , Aspartate Aminotransferases/blood , Autoantibodies/blood , Azathioprine/therapeutic use , Child , Female , Genotype , Hepacivirus/genetics , Hepacivirus/immunology , Hepatitis C/drug therapy , Hepatitis, Autoimmune/drug therapy , Hepatitis, Autoimmune/virology , Humans , Immunoglobulin G/blood , Immunosuppressive Agents , Liver/pathology , Prednisone/therapeutic use , RNA, Viral/blood , SyndromeABSTRACT
We evaluated the prevalence and transmission mode of hepatitis B and C in an inner-city, pediatric cohort of human immunodeficiency virus (HIV)-infected persons, as well as the demographic characteristics of the cohort. Hepatitis B or C was found in 13 (5.8%) of 228 children. This analysis suggests that chronic hepatitis is prevalent and should be routinely screened for in the pediatric HIV-infected population.