アレルギーと治療のジャーナル

概要

Comparison of Food and Aeroallergen Sensitivity between Adults and Children with Eosinophilic Esophagitis

Prematta T, Kunselman A and Ghaffari G

Rationale: Eosinophilic esophagitis (EoE) is an increasingly diagnosed disorder and evidence suggests that food and/or aeroallergen sensitivities play a role in the pathogenesis. The purpose of this study was to compare the likelihood of food and aeroallergen sensitivity in children versus adults with EoE.

Methods: After institutional review board approval, a retrospective chart review was conducted evaluating the work up performed on patients with EoE referred to allergists. A comparison was made between sensitivity to foods and aeroallergens based on age (children ≤ 18 years compared to adults ≥ 19 years).

Results: Medical records of 44 patients with biopsy proven diagnosis of EoE were reviewed retrospectively (19 children and 25 adults). Compared with adults, children had significantly more evidence of IgE mediated sensitivity to egg (59% versus 9%; OR 13.2; 95% CI: 2.1-152.3; P = 0.002), milk (61% versus 9%; OR 14.4; 95% CI: 2.4- 165.8; P value = 0.001), and soy (61% versus 14%; OR 9.3; 95% CI: 1.8-67.7; P = 0.005). Children tended to have higher rates of positive patch testing to foods, but these differences did not reach statistical significance. IgE mediated aeroallergen sensitivities were not statistically different between children and adults when evaluating for trees, grasses, weeds, dust mites, animal danders and molds.

Conclusion: Our study suggests that among patients with EoE, children are more likely to have IgE mediated food sensitivities to egg, milk, and soy, when compared with adults. However, the occurrence of aeroallergen sensitivity in children and adults with EoE is similar. In the future, large prospective studies will help better delineate the association of EoE with food and aeroallergen sensitivity. This will potentially lead to appropriate interventions in different age groups.