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The Prevalence of Biopsy-Proven Eosinophilic Esophagitis in Hispanics Undergoing Endoscopy Is Infrequent Compared to Caucasians: A Cross-Sectional Study

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Abstract

Introduction

The prevalence of eosinophilic esophagitis (EoE), a chronic, immune-mediated, clinicopathologic, inflammatory disorder, has been well described in the pediatric and adult Caucasian population but not as well studied in the Hispanic population. The major aims of this study are to determine the prevalence and gene expression profile of EoE in these populations.

Methods

This is a retrospective cohort study of patients from two institutions predominantly serving a Hispanic population. Patients included at Los Angeles County Hospital (LACH) had an esophagogastroduodenoscopy (EGD) and esophageal biopsies performed for evaluation of dysphagia and/or food impaction, while patients included from the University Hospital Medical Center of El Paso (UHMCEP) had an EGD and esophageal biopsies performed for any appropriate clinical indication. Gene expression analysis which has been shown to accurately diagnose EOE in Caucasians was performed for 9 patients at UHMCEP to determine its accuracy in Hispanics.

Results

At LACH, 234 patients were included in the study of whom 155 (66.3%) were Hispanic and 22 (9.4%) were Caucasian. 3.2% of the Hispanic patients and 9.1% of the Caucasian patients were diagnosed with EOE with threefold difference. At UHMCEP 1700 patients were included of whom 1350 (79.4%) were Hispanic and 179 (10.5%) were Caucasian. 0.96% of the Hispanic patients and 7.26% of the Caucasian patients were diagnosed with EOE with a sevenfold difference. Gene expression accurately diagnosed EOE in a small number of both Hispanics and Caucasians who underwent analysis.

Conclusions

Hispanic patients at LAC and UMHCEP had a significantly lower prevalence of EOE as compared to Caucasians at these two institutions and a lower prevalence as compared to Caucasians with EOE previously reported in the literature. Gene expression analysis, which has previously been shown to accurately diagnose EOE in Caucasian patients, accurately diagnosed EOE in a small sample of this Hispanic population. Based on this similar gene expression, other factors such as environmental, ethnic, and cultural causes should be investigated to explain the markedly lower prevalence of EOE in Hispanics.

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References

  1. Prasad GA, Talley NJ, Romero Y, et al. Prevalence and predictive factors of eosinophilic esophagitis in patients presenting with dysphagia: a prospective study. Am J Gastroenterol. 2007;102:2627–2632.

    Article  PubMed  Google Scholar 

  2. Soon IS, Butzner JD, Kaplan GG, et al. Incidence and prevalence of eosinophilic esophagitis in children. J Pediatr Gastroenterol Nutr. 2013;57:72–80.

    Article  PubMed  Google Scholar 

  3. Spergel JM, Book WM, Mays E, et al. Variation in prevalence, diagnostic criteria, and initial management options for eosinophilic gastrointestinal diseases in the Unites States. J Pediatr Gastroenterol Nutr. 2011;52:300–306.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Whitney-Miller CL, Katzka D, Furth EE. Eosinophilic esophagitis; a retrospective review of esophageal biopsy specimens from 1992 to 2004 at an adult academic medical center. Am J Clin Pathol. 2009;131:788–792.

    Article  PubMed  Google Scholar 

  5. Straumann A, Simon HU. Eosinophilic esophagitis: escalating epidemiology? J Allergy Clin Immunol. 2005;115:418–419.

    Article  PubMed  Google Scholar 

  6. Ronkainen J, Talley NJ, Aro P, et al. Prevalence of esophageal eosinophils and eosinophilic esophagitis in adults: the population based Kalixanda study. Gut. 2007;56:615–620.

    Article  PubMed  Google Scholar 

  7. Mackenzie SH, Go M, Chadwick B, et al. Clinical trial: eosinophilic esophagitis in patients presenting with dysphagia—a prospective analysis. Aliment Pharmacol Ther. 2008;28:1140–1146.

    Article  CAS  PubMed  Google Scholar 

  8. Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128:3–20.

    Article  PubMed  Google Scholar 

  9. Dellon ES, Gonsalves N, Hirano I, et al. ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol. 2013;108:679–692.

    Article  PubMed  Google Scholar 

  10. Dellon ES. Epidemiology of eosinophilic esophagitis. Gastroenterol Clin North Am. 2014;43:201–218.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sgouros SN, Bergele C, Mantides A. Eosinophilic esophagitis in adults: a systematic review. Eur J Gastroenterol Hepatol. 2006;18:211–217.

    Article  PubMed  Google Scholar 

  12. Liacouras CA. Eosinophilic esophagitis in children and adults. J Pediatric Gastroenterol Nutr. 2003;37:S23–S28.

    Article  Google Scholar 

  13. Kapel RC, Miller JK, Torres C, et al. Eosinophilic esophagitis: a prevalent disease in the United States that affects all age groups. Gastroenterology. 2008;134:1316–1321.

    Article  PubMed  Google Scholar 

  14. Gonsalves N. Eosinophilic esophagitis: history, nomenclature, and diagnostic guidelines. Gastrointest Endosc Clin N Am. 2008;18:1–9.

    Article  PubMed  Google Scholar 

  15. Rothenberg ME, Mishra A, Collins MH, et al. Pathogenesis and clinical features of eosinophilic esophagitis. J Allergy Clin Immunol. 2001;108:891–894.

    Article  CAS  PubMed  Google Scholar 

  16. Potter JW, Saean K, Staff D, et al. Eosinophilic esophagitis in adults: an emerging problem with unique esophageal features. Gastrointest Endosc. 2004;59:355–361.

    Article  PubMed  Google Scholar 

  17. Fox VL, Nurko S, Furuta GT. Eosinophilic esophagitis: it’s not just kid’s stuff. Gastrointest Endosc. 2002;56:260–270.

    Article  PubMed  Google Scholar 

  18. Croese J, Fairley SK, Masson JW, et al. Clinical and endoscopic features of eosinophilic esophagitis in adults. Gastrointest Endosc. 2003;58:516–522.

    Article  PubMed  Google Scholar 

  19. Remedios M, Campbell C, Jones DM, et al. Eosinophilic esophagitis in adults: clinical, endoscopic, histologic findings, and response to treatment with fluticasone proprionate. Gastrointest Endosc. 2006;63:3–12.

    Article  PubMed  Google Scholar 

  20. Bohm M, Sebastiano ZA, Malik ZA et al. Racial differences in symptoms and endoscopic findings in adults with eosinophilic esophagitis: a 10 year experience in an urban hospital. Sa1173. Gastroenterology. 2010;140: S-244.

  21. Byrne KR, Panagiotakis PH, Hilden K, et al. Retrospective analysis of esophageal food impaction: differences in etiology by age and gender. Dig Dis Sci. 2007;52:717–721.

    Article  PubMed  Google Scholar 

  22. Moawad FJ, Dellon ES, Achem SR, et al. Effects of race and sex of features of eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2016;14:23–30.

    Article  PubMed  Google Scholar 

  23. Sperry SL, Woosley JT, Shaheen NJ, et al. Influence of race and gender on the presentation of eosinophilic esophagitis. Am J Gastroenterol. 2012;107:215–221.

    Article  PubMed  Google Scholar 

  24. Ito J, Fujiwara T, Kojima R, et al. Racial differences in eosinophilic gastrointestinal disorders among Caucasian and Asian. Allergol Int. 2015;64:253–259.

    Article  PubMed  Google Scholar 

  25. Wen T, Stucke EM, Grotjan TM, et al. Molecular diagnosis of eosinophilic esophagitis by gene expression profiling. Gastroenterology. 2013;145:1289–1299.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Kim S, Kim S, Sheikh J. Prevalence of eosinophilic esophagitis in a population-based cohort from Southern California. J Allergy Clin Immunol Pract. 2015;3:978–979.

    Article  PubMed  Google Scholar 

  27. Genta RM, Spechler SJ. Mo1853 low prevalence of eosinophilic esophagitis in hispanics and asians in the United States. Gastroenterology 2014; 146:S-673.

  28. Hirano I, Moy N, Heckman MG, et al. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system. Gut. 2013;62:89–95.

    Article  Google Scholar 

  29. Malaty HM, Evans DG, Evans DJ Jr, et al. Helicobacter pylori in Hispanics: comparison with blacks and whites of similar age and socioeconomic class. Gastroenterology. 1992;103:813–816.

    Article  CAS  PubMed  Google Scholar 

  30. Khalifa MM, Sharaf RR, Aziz RK. Helicobacter pylori: a poor man’s gut pathogen? Gut Pathogens. 2010;2:2.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Molina-Infante J, Savarino E, Modolell I, et al. Mo1173: association between eosinophilic esophagitis and Helicobacter pylori infection: preliminary results of a multi center study. Gastroenterology. 2016;150:S657–S658.

    Article  Google Scholar 

  32. Dellon ES, Peery AF, Shaheen NJ, et al. Inverse association of esophageal eosinophilia with helicobacter pylori based on analysis of a US pathology database. Gastroenterol. 2011;141:1586–1592.

    Article  Google Scholar 

  33. Ronkainen J, Talley NJ, Aro P, et al. Prevalence of esophageal eosinophils and eosinophilic esophagitis in adults: the population-based Kalixanda study. Gut. 2007;57:615–620.

    Article  Google Scholar 

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Correspondence to Richard W. McCallum.

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Yu, C., Sterling, D., Albayati, I. et al. The Prevalence of Biopsy-Proven Eosinophilic Esophagitis in Hispanics Undergoing Endoscopy Is Infrequent Compared to Caucasians: A Cross-Sectional Study. Dig Dis Sci 62, 3511–3516 (2017). https://doi.org/10.1007/s10620-017-4791-8

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  • DOI: https://doi.org/10.1007/s10620-017-4791-8

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