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Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests.
- Source :
-
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology [Ann Allergy Asthma Immunol] 2005 Oct; Vol. 95 (4), pp. 336-43. - Publication Year :
- 2005
-
Abstract
- Background: Eosinophilic esophagitis (EE) is a recently described disorder identified in patients with symptoms suggestive of gastroesophageal reflux disease (GERD) but unresponsive to conventional reflux therapies. Therapies have included corticosteroids, elemental diet, and diet restriction. We report our experience with skin prick and atopy patch testing and food elimination diets in patients diagnosed as having EE.<br />Objective: To identify food antigens that cause EE and the characteristics of patients who respond to food elimination vs those who are unresponsive.<br />Methods: Patients diagnosed as having EE had restricted diets based on skin prick and atopy patch testing results. Additional biopsies were performed after 4 to 8 weeks of restricted diet. Demographics, atopic tendencies, and food antigens were identified retrospectively in our food allergy database.<br />Results: A total of 146 patients diagnosed as having EE were evaluated with skin prick and atopy patch testing. Thirty-nine patients had unequivocal demonstration of food causing EE, with normalization of biopsy results on elimination and reoccurrence on reintroduction. An additional 73 patients, for a total 112 (77%) of 146 patients, had resolution of their EE as demonstrated by biopsy results. Fifteen (10%) of 146 patients were nonresponders manifested by no significant reduction in esophageal eosinophils despite restricted diet based on skin prick and atopy patch testing. Egg, milk, and soy were identified most frequently with skin prick testing, whereas corn, soy, and wheat were identified most frequently with atopy patch testing.<br />Conclusion: In more than 75% of patients with EE, both symptoms and esophageal inflammation can be significantly improved with dietary elimination of foods. Skin prick and atopy patch testing can help identify foods in most patients.
- Subjects :
- Adolescent
Adult
Allergens adverse effects
Allergens analysis
Animals
Biopsy
Child
Child, Preschool
Eosinophilia diagnosis
Esophagitis diagnosis
Esophagitis pathology
Esophagus pathology
Female
Food Hypersensitivity diagnosis
Food Hypersensitivity etiology
Food Hypersensitivity pathology
Humans
Infant
Male
Milk adverse effects
Ovum
Skin Tests methods
Soy Foods adverse effects
Treatment Outcome
Triticum adverse effects
Zea mays adverse effects
Eosinophilia diet therapy
Esophagitis diet therapy
Food Hypersensitivity diet therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1081-1206
- Volume :
- 95
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
- Publication Type :
- Academic Journal
- Accession number :
- 16279563
- Full Text :
- https://doi.org/10.1016/S1081-1206(10)61151-9