Race and Gender Influences the Presentation of Eosinophilic Esophagitis.
Girish Hiremath, Aaron Yazdian, Ifeanyi Onuh and 2 others
PMID 37069435WHAT IT FOUND
African American patients with eosinophilic esophagitis were diagnosed younger and had fewer esophageal furrows than White patients.
Males were diagnosed earlier than females and showed more abnormal endoscopic findings. These differences persisted after adjusting for confounders.
Key findings
01African American patients were significantly younger at diagnosis and had lower odds of having esophageal furrows on endoscopy compared to White patients.
02Males were diagnosed at a younger age than females and had higher odds of abnormal endoscopic findings.
03The annualized prevalence of eosinophilic esophagitis was highest in White patients compared to African American and Other racial groups.
STILL TO COME
How it was doneWhat they found
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What it does not show
This was a single-center retrospective study, so results may not be generalizable to other populations or settings. The cohort was overwhelmingly White (88%), limiting the statistical power for comparisons involving African American and 'Other' racial groups. Race and gender were self-reported, which introduces potential reporting bias. ICD codes may have been inaccurate, potentially missing some cases or including incorrect diagnoses. Symptoms like abdominal pain are not specific to EoE and may have been influenced by other conditions. A high proportion (54%) of patients had normal-appearing esophagi on endoscopy, which is unusual and may reflect differences in documentation or endoscopist experience.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-U.S. government and NIH grants.
The easy way to misread this
Do not assume that the absence of esophageal furrows in African American patients rules out eosinophilic esophagitis, as this is a statistical association from a single center, not a diagnostic criterion. Additionally, the study does not establish causality for the observed racial and gender differences in presentation.