Value of Food Patch Testing in Pediatric and Adult Patients with Eosinophilic Esophagitis and Eosinophilic Colitis

Abstract

RationaleEosinophilic Esophagitis (EE) and Eosinophilic Colitis (EC) are emerging diagnoses in the field of allergy and immunology. Food patch testing, in conjunction with skin prick test (SPT) and/or in vitro specific serum IgE, provides additional information to detect possible implicated foods.MethodsPatients with biopsy proven diagnosis of EE or EC were evaluated in allergy clinic. Detailed history was obtained and complete physical exam was performed. SPT and/or specific serum IgE delineated IgE-mediated reactions. Food patch testing was performed to detect delayed type hypersensitivity reactions.ResultsWe evaluated 14 patients (7 male, 7 female) with biopsy proven diagnosis of EE and EC in allergy and immunology clinic. Eleven patients had EE and 3 patients had EC. Four patients were in pediatric age group (age range:1.5 to 13 years). The food patch testing was positive in 8 patients. It was positive to at least to two foods in all pediatric patients. The most common foods that were identified by food patch testing were turkey (3) followed by chicken (2), carrot (2), corn (2), beef (1), oat (1), soy (1), peas (1), milk (1) and peanuts (1). Based on the results, recommendations regarding avoidance of triggering foods were formulated and discussed with the patients.ConclusionIn patients with EE or EC, identifying the possible food triggers by food patch testing will help formulate the appropriate food avoidance which can potentially improve symptoms. RationaleEosinophilic Esophagitis (EE) and Eosinophilic Colitis (EC) are emerging diagnoses in the field of allergy and immunology. Food patch testing, in conjunction with skin prick test (SPT) and/or in vitro specific serum IgE, provides additional information to detect possible implicated foods. Eosinophilic Esophagitis (EE) and Eosinophilic Colitis (EC) are emerging diagnoses in the field of allergy and immunology. Food patch testing, in conjunction with skin prick test (SPT) and/or in vitro specific serum IgE, provides additional information to detect possible implicated foods. MethodsPatients with biopsy proven diagnosis of EE or EC were evaluated in allergy clinic. Detailed history was obtained and complete physical exam was performed. SPT and/or specific serum IgE delineated IgE-mediated reactions. Food patch testing was performed to detect delayed type hypersensitivity reactions. Patients with biopsy proven diagnosis of EE or EC were evaluated in allergy clinic. Detailed history was obtained and complete physical exam was performed. SPT and/or specific serum IgE delineated IgE-mediated reactions. Food patch testing was performed to detect delayed type hypersensitivity reactions. ResultsWe evaluated 14 patients (7 male, 7 female) with biopsy proven diagnosis of EE and EC in allergy and immunology clinic. Eleven patients had EE and 3 patients had EC. Four patients were in pediatric age group (age range:1.5 to 13 years). The food patch testing was positive in 8 patients. It was positive to at least to two foods in all pediatric patients. The most common foods that were identified by food patch testing were turkey (3) followed by chicken (2), carrot (2), corn (2), beef (1), oat (1), soy (1), peas (1), milk (1) and peanuts (1). Based on the results, recommendations regarding avoidance of triggering foods were formulated and discussed with the patients. We evaluated 14 patients (7 male, 7 female) with biopsy proven diagnosis of EE and EC in allergy and immunology clinic. Eleven patients had EE and 3 patients had EC. Four patients were in pediatric age group (age range:1.5 to 13 years). The food patch testing was positive in 8 patients. It was positive to at least to two foods in all pediatric patients. The most common foods that were identified by food patch testing were turkey (3) followed by chicken (2), carrot (2), corn (2), beef (1), oat (1), soy (1), peas (1), milk (1) and peanuts (1). Based on the results, recommendations regarding avoidance of triggering foods were formulated and discussed with the patients. ConclusionIn patients with EE or EC, identifying the possible food triggers by food patch testing will help formulate the appropriate food avoidance which can potentially improve symptoms. In patients with EE or EC, identifying the possible food triggers by food patch testing will help formulate the appropriate food avoidance which can potentially improve symptoms.