P3C139: Impact of Gender, Race and Age of Onset on the Phenotype and Comorbidities of Pediatric Eosinophilic Esophagitis

Background: Eosinophilic esophagitis (EoE) is recognized as a chronic immunologic disorder of the esophagus resulting in esophageal inflammation by the accumulation of eosinophils in the epithelium. Several risk factors are thought to be associated with the development of EoE, but because of its complex underlying mechanisms of disease, there is little clarity in regards to the different symptoms experienced, pathological findings, and associated comorbidities including atopic and allergic disorders between different gender, race, and age of onset.

Methods: This study utilized a retrospective chart review of the patients seen by a multidisciplinary EoE clinic from January 2020 to December 2022. Subjects were diagnosed with EoE, and retrospectively assessed for eosinophilic counts on the initial distal and proximal esophageal biopsies, and previously specified symptoms and comorbidities. The differences in eosinophilic counts, associated symptoms, and comorbidities between gender (male or female), race (White or non-White), and age of onset (≤ 6 years old is defined as early onset, or > 6 years old is defined as regular onset in this study), were statistically analyzed by t-test or Chi-Square. P< 0.05 is considered as significant.

Results: Ninety patients were included in this study, of whom 72% are male (M) while 28% are female (F), 68% are White (W) and 32% are non-White (NW). Age of onset ranges from 1 year to 17 years, with 44% being early onset (EO) and 56% being regular onset (RO). We found females and the White race were significantly more likely to report dysphagia. Non-White patients were found to have a higher incidence of vomiting, and asthma than White. A significantly higher incidence of vomiting and eosinophilic counts was found in early-onset patients (distal: 56, proximal: 50) compared to regular onset (distal: 39, proximal: 39), while no significant difference was found between different gender and race (Figure).

Conclusion: Our retrospective study demonstrated that there are significant differences between different gender, race, and age of onset for pediatric EoE in regard to the severity of eosinophilic inflammation, gastrointestinal symptoms, and associated comorbidities. These findings could provide some guidance to clinicians in identifying proper diagnoses and developing appropriate treatments to achieve the best outcome.