RESUMEN
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.
Asunto(s)
Esofagitis Eosinofílica/etnología , Alérgenos/inmunología , Instituciones de Atención Ambulatoria , Biopsia , Niño , Preescolar , Ciudades , Esofagitis Eosinofílica/sangre , Esofagitis Eosinofílica/inmunología , Eosinófilos/inmunología , Esófago/inmunología , Esófago/patología , Femenino , Hospitales Urbanos , Humanos , Inmunoglobulina E/sangre , Masculino , Grupos Raciales , Estudios RetrospectivosAsunto(s)
Bezoares/terapia , Bebidas Gaseosas , Estómago/lesiones , Preescolar , Femenino , Humanos , Resultado del TratamientoAsunto(s)
Hepacivirus , Hepatitis C/diagnóstico , Hepatitis Autoinmune/diagnóstico , Alanina Transaminasa/sangre , Anticuerpos Antivirales/sangre , Aspartato Aminotransferasas/sangre , Autoanticuerpos/sangre , Azatioprina/uso terapéutico , Niño , Femenino , Genotipo , Hepacivirus/genética , Hepacivirus/inmunología , Hepatitis C/tratamiento farmacológico , Hepatitis Autoinmune/tratamiento farmacológico , Hepatitis Autoinmune/virología , Humanos , Inmunoglobulina G/sangre , Inmunosupresores , Hígado/patología , Prednisona/uso terapéutico , ARN Viral/sangre , SíndromeRESUMEN
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.