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The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis.
J Allergy Clin Immunol 2002; 109(2):363-8JA

Abstract

BACKGROUND

Eosinophilic esophagitis is a disease entity in which patients have (1) elevated eosinophils on esophageal biopsy and (2) symptoms of gastroesophageal reflux. The symptoms do not improve on aggressive acid blockade but do improve on elimination diet or corticosteroid treatment, which tentatively links food allergies to this disorder.

OBJECTIVE

The purpose of this study was to identify potential food antigens in eosinophilic esophagitis.

METHODS

Patients with eosinophilic esophagitis were identified by biopsy. Potential food antigens were identified prospectively by skin prick testing and patch testing, which were performed through use of standard methods. Atopic tendencies, demographics, and potential food allergies were identified. Repeat esophageal biopsies were reviewed when possible.

RESULTS

A total of 26 patients (22 male, 4 female) with a biopsied-confirmed diagnosis of eosinophilic esophagitis underwent both skin prick testing and patch testing to identify potential causative foods. Milk and egg were the most common positive foods with skin prick testing. Wheat was the most common positive food with patch testing. The patients were advised to avoid positive foods as identified by skin prick testing and patch testing. In all, 18 patients had resolution of their symptoms, 6 patients had partial improvement, and 2 were lost to follow-up. Overall, after intervention, esophageal eosinophil counts improved from 55.8 to 8.4 eosinophils per high-power field. The foods most commonly identified by patients as causing symptoms were milk and egg.

CONCLUSION

The combination of skin prick testing and patch testing can identify potential causative foods that might contribute to the pathogenesis of eosinophilic esophagitis.

Authors+Show Affiliations

Allergy Section, Division of Immunologic and Infectious Disease, The Children's Hospital of Philadelphia, PA 19104, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11842310

Citation

Spergel, Jonathan M., et al. "The Use of Skin Prick Tests and Patch Tests to Identify Causative Foods in Eosinophilic Esophagitis." The Journal of Allergy and Clinical Immunology, vol. 109, no. 2, 2002, pp. 363-8.
Spergel JM, Beausoleil JL, Mascarenhas M, et al. The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis. J Allergy Clin Immunol. 2002;109(2):363-8.
Spergel, J. M., Beausoleil, J. L., Mascarenhas, M., & Liacouras, C. A. (2002). The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis. The Journal of Allergy and Clinical Immunology, 109(2), pp. 363-8.
Spergel JM, et al. The Use of Skin Prick Tests and Patch Tests to Identify Causative Foods in Eosinophilic Esophagitis. J Allergy Clin Immunol. 2002;109(2):363-8. PubMed PMID: 11842310.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis. AU - Spergel,Jonathan M, AU - Beausoleil,Janet L, AU - Mascarenhas,Maria, AU - Liacouras,Chris A, PY - 2002/2/14/pubmed PY - 2002/3/26/medline PY - 2002/2/14/entrez SP - 363 EP - 8 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 109 IS - 2 N2 - BACKGROUND: Eosinophilic esophagitis is a disease entity in which patients have (1) elevated eosinophils on esophageal biopsy and (2) symptoms of gastroesophageal reflux. The symptoms do not improve on aggressive acid blockade but do improve on elimination diet or corticosteroid treatment, which tentatively links food allergies to this disorder. OBJECTIVE: The purpose of this study was to identify potential food antigens in eosinophilic esophagitis. METHODS: Patients with eosinophilic esophagitis were identified by biopsy. Potential food antigens were identified prospectively by skin prick testing and patch testing, which were performed through use of standard methods. Atopic tendencies, demographics, and potential food allergies were identified. Repeat esophageal biopsies were reviewed when possible. RESULTS: A total of 26 patients (22 male, 4 female) with a biopsied-confirmed diagnosis of eosinophilic esophagitis underwent both skin prick testing and patch testing to identify potential causative foods. Milk and egg were the most common positive foods with skin prick testing. Wheat was the most common positive food with patch testing. The patients were advised to avoid positive foods as identified by skin prick testing and patch testing. In all, 18 patients had resolution of their symptoms, 6 patients had partial improvement, and 2 were lost to follow-up. Overall, after intervention, esophageal eosinophil counts improved from 55.8 to 8.4 eosinophils per high-power field. The foods most commonly identified by patients as causing symptoms were milk and egg. CONCLUSION: The combination of skin prick testing and patch testing can identify potential causative foods that might contribute to the pathogenesis of eosinophilic esophagitis. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/11842310/The_use_of_skin_prick_tests_and_patch_tests_to_identify_causative_foods_in_eosinophilic_esophagitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091674902794670 DB - PRIME DP - Unbound Medicine ER -