The Prevalence of Eosinophilic Esophagitis in Pediatric Patients with IgE-Mediated Food Allergy

Abstract

BACKGROUND Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Recently, EoE has been identified in patients undergoing oral immunotherapy (OIT) for IgE-mediated food allergy, suggesting an association. OBJECTIVE We sought to ascertain whether significant associations exist between IgE-mediated food allergies and EoE. METHODS Utilizing analysis of EMR data and manual chart review, we examined our sub-specialty care network of 35,528 children and adolescents to identify and characterize patients with IgE-mediated, and EoE food allergy. The most common food allergens were defined, and the prevalence of EoE in patients with IgE-mediated food allergy was determined. Logistic regression was used to measure the extent to which IgE-mediated food allergy to specific foods is associated with EoE. RESULTS The most common causes of EoE were milk, grains, meats, peanut, tree nuts, egg, and soy, an allergen pattern that is distinct from that of IgE-mediated food allergy. The prevalence of EoE in patients with IgE-mediated food allergy was higher than that reported in the general population (4.7% vs 0.04%). The distribution of IgE-mediated food allergens in patients with EoE was similar to that of the general population, and IgE-mediated allergy to egg (2.27; 1.91–2.64), milk (4.19; 3.52–4.97), or shellfish (1.55; 1.24–1.92) was significantly associated with EoE diagnosis. CONCLUSIONS Our findings support a clinical association between these conditions that has implications for the management of children with food allergy, and particular relevance to patients undergoing OIT.

Treatment of gastric eosinophilia by epicutaneous immunotherapy in piglets sensitized to peanuts

“…Recommendations in diagnostics, genetics, allergy testing, therapeutics and disease complications have been published by various work groups . Patients have high rates of concurrent food sensitivities, and it has been recently reported by Hill et al that 68% of EoE patients have IgE‐mediated food allergy . Elimination diet/amino‐acid feedings are one of the mainstays of treatment in young children .…”

“…[2][3][4] Patients have high rates of concurrent food sensitivities, 5 and it has been recently reported by Hill et al that 68% of EoE patients have IgE-mediated food allergy. 6 Elimination diet/ amino-acid feedings are one of the mainstays of treatment in young children. 7 Diagnostic criteria for other EGIDS, including eosinophilic gastritis, are less well defined, but Caldwell et al 8 neous immunotherapy (EPIT) in peanut allergic children, 9 we have decided to investigate the impact of EPIT on EGIDs.…”

Gastrointestinal Food Allergy in Children

“…Наиболее часто в качестве причинно-значимых продуктов выступают молоко, соя, яйца, зерновые, различные виды мяса [26].…”

Screening children for eosinophilic esophagitis: allergic and other risk factors

“…96-4.62). Using a large pediatric virtual birth cohort, we have measured these risk relationships in individuals revealed that history of AD (hazard ratio [HR] 3.2, 95% confidence interval [CI] 2.2-4.6), IgE-mediated food allergy (IgE-FA; HR 9.1, 95% CI 6.5-12.6), and asthma (HR 1.9, 95% CI 1.3-2.7) are independently and cumulatively associated with subsequent EoE diagnosis (Table 1) [11].The relationship between IgE-FA and EoE is particularly strongchildren with IgE-FA develop EoE at 9 times the rate of children without IgE-FA [12]. IgE-FA and EoE have…”

“…The relationship between IgE-FA and EoE is particularly strongchildren with IgE-FA develop EoE at 9 times the rate of children without IgE-FA [12]. IgE-FA and EoE have…”