Abnormal Responses to Local Esophageal Food Allergen Injections in Adult Patients With Eosinophilic Esophagitis.

Abstract:

:Skin tests and measurement of serum levels of immunoglobulin E do not accurately identify foods for elimination from the diets of patients with eosinophilic esophagitis (EoE). We investigated whether an esophageal prick test, in which the esophageal mucosa is challenged by local injection of allergen extracts, could identify individuals with esophageal sensitization. During endoscopy, 6 allergens were injected in the esophagus of 8 patients with EoE and 3 patients without EoE (controls). A second endoscopy was performed after 24 hours to evaluate delayed responses. Five of the 8 patients with EoE had evidence for an acute response (luminal obstruction and mucosal blanching); 2 other patients had a delayed wheal or flare reaction. No responses were observed in controls. We conclude that esophageal mucosal food allergen injections induce acute and/or delayed responses in patients with EoE but not controls. The esophageal prick test deserves further exploration because it may guide elimination diets.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Warners MJ,Terreehorst I,van den Wijngaard RM,Akkerdaas J,van Esch BCAM,van Ree R,Versteeg SA,Smout AJPM,Bredenoord AJ

doi

10.1053/j.gastro.2017.08.062

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

57-60.e2

issue

1

eissn

0016-5085

issn

1528-0012

pii

S0016-5085(17)36095-X

journal_volume

154

pub_type

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