Successful food elimination therapy in adult eosinophilic esophagitis: not all patients are the same

Journal of Clinical Gastroenterology
Jesús González-CerveraAlfredo J Lucendo

Abstract

Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated, esophageal disease characterized by esophageal dysfunction and eosinophilic inflammation, manifested mainly as dysphagia and frequent food impaction. EoE is recognized into the spectrum of food allergy, but food sensitization studies used not to be efficient to identify the triggering food, because of what patients are frequently treated with topic steroids or even endoscopic esophageal dilation. Herein, we describe 3 adult patients-all suffering from EoE, but with different sensitization patterns-who were treated successfully with elimination diets. Allergy tests indicated no food sensitization for patient 1, but challenge with milk and wheat were positive. Food IgE-mediated allergies were found in patients 2 and 3; inflammation was resolved with food elimination. Lack of food allergy sensitization does not exclude the possibility of food allergies as a cause of EoE; elimination diets must therefore be considered as an effective diagnostic and treatment tool.

References

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Citations

May 22, 2013·Current Opinion in Gastroenterology·Ronak Vashi, Ikuo Hirano
Nov 18, 2014·Clinical Practice·Asifa K ZaidiAnil Mishra
Oct 13, 2015·Pediatric Clinics of North America·Rebecca Sharon ChinthrajahKari Nadeau
Oct 16, 2016·American Journal of Physiology. Gastrointestinal and Liver Physiology·Leon A SokulskyJoerg Mattes
Mar 20, 2013·Journal of Clinical Gastroenterology·Dan Segal, Nilesh Chande
Nov 22, 2012·Expert Review of Clinical Immunology·Alfredo J Lucendo, Marta Sánchez-Cazalilla
Nov 19, 2013·Expert Review of Clinical Immunology·Angel Arias, Alfredo J Lucendo
Mar 8, 2014·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·B DoerflerN Gonsalves
Jun 3, 2014·Current Opinion in Gastroenterology·Nirmala Gonsalves

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