Influence of hispanic ethnicity on the presentation and treatment response in pediatric patients with eosinophilic esophagitis

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Abstract Objectives Eosinophilic esophagitis (EoE) is a chronic, immune‐mediated disease with rising incidence globally. Described predominantly in White populations, the clinical features of EoE in Hispanic children are poorly characterized. This study evaluated the clinical, endoscopic, histologic, and treatment characteristics of Hispanic versus Non‐Hispanic pediatric patients with EoE. Methods We conducted a retrospective comparative cohort study of pediatric patients newly diagnosed with EoE. Hispanic patients were compared 1:1 with non‐Hispanic. Clinical, atopic, endoscopic, histologic, and treatment data were abstracted from medical records. Multivariate logistic regression identified features associated with Hispanic ethnicity. Results One hundred and eighty‐six patients (93 Hispanic, 93 non‐Hispanic) were included. Hispanic patients had longer symptom duration before diagnosis, were more likely to present with weight loss (odds ratio [OR] 10.16, 95% confidence interval [CI] 3.00–34.41) and asthma (OR 3.7, 95% CI 1.28–10.66), and less likely to have immunoglobulin E‐mediated food allergy (OR 0.07, 95% CI 0.02–0.23). Endoscopically, they were more likely to have a normal‐appearing esophagus (OR 21.07, 95% CI 3.47–127.83) with fewer furrows; however, when abnormal endoscopic findings were present, exudates were more common (OR 3.3, 95% CI 1.06–10.28). Histologic activity was comparable across groups. Treatment responses were similar overall, though remission with proton pump inhibitors was more common in Hispanic patients. Conclusions Hispanic pediatric patients with EoE exhibit distinct clinical features, which may reflect differences in clinical presentation and healthcare‐related factors that were not directly measured. These observations underscore the need for heightened clinical awareness and tailored strategies to reduce disparities in diagnosis and access to care among Hispanic patients.