Volume 10 Supplement 1
Diagnostic yield of allergy testing in Pediatric Eosinophilic Esophagitis: a 10 year experience at a tertiary care centre
© Tutelman et al; licensee BioMed Central Ltd. 2014
Published: 3 March 2014
Eosinophilic Esophagitis (EoE) is a disease in children characterized by esophageal dysfunction and eosinophilic infiltration . Patients frequently present with an atopic history; therefore, allergy testing by both skin prick and food patch testing are often performed. However, the utility of allergy testing remains unclear [1, 3]. Treatment with topical corticosteroids may be needed for clinical and histologic improvement if allergic triggers are not identified [1, 2]. However, the natural history of EoE suggests that this condition is chronic and may recur when corticosteroids are withdrawn . Therefore, treatment with dietary/aeroallergen avoidance is preferable to reduce the need for oral corticosteroids, while preventing exacerbation of EoE . This study aims to describe the atopic characteristics of a pediatric cohort with EoE over a 10 year period at a tertiary care center.
All children (< 18 years) who had esophagogastroduodenoscopy with biopsy proven EoE (15+ eosinophils per high power field) at McMaster Children’s Hospital between January 2003 and December 2012 were identified and their medical records reviewed. Data pertaining to patient demographics, symptoms at diagnosis, atopic history, endoscopic and histologic findings, results of allergy testing (skin prick, patch and immunoCAP) and treatment outcomes were extracted.
Pediatric EoE is considered to be an allergic disease with both environmental and food allergen triggers in many patients. A majority of patients present with a history of atopy and show positive allergy test results to both foods and aeroallergens. Both environmental and food allergen elimination should be considered a part of a therapeutic program. Identification of offending allergens by allergy skin and patch testing can be an important factor in guiding clinical decision making.
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