Dichotomy of food and inhalant allergen sensitization in eosinophilic esophagitis

Sugnanam, K. K. N., Collins, J. T., Smith, P. K., Connor, F., Lewindon, P., Cleghorn, G. and Withers, G. (2007-11) Dichotomy of food and inhalant allergen sensitization in eosinophilic esophagitis. Allergy, 62 11: 1257-1260.

Document type:	Journal Article
Collections:	Excellence in Research Australia (ERA) - Collection 2008 Higher Education Research Data Collection School of Medicine Publications

Author(s)	Sugnanam, K. K. N. Collins, J. T. Smith, P. K. Connor, F. Lewindon, P. Cleghorn, G. Withers, G.
Title	Dichotomy of food and inhalant allergen sensitization in eosinophilic esophagitis
Journal name	Allergy
Publication date	2007-11
Sub-type	Article
Volume number	62
Issue number	11
ISSN	0105-4538; 1398-9995
Start page	1257
End page	1260
Total pages	4
Editor(s)	J. Bousquet
Place of publication	Oxford
Publisher	Blackwell Publishing
Collection year	2008
Language	eng
Subject	730204 Child health 321006 Gastroenterology and Hepatology C1
Formatted abstract	Background: Eosinophilic esophagitis (EE) is an emerging condition where patients commonly present with symptoms of gastroesophageal reflux disease and fail to respond adequately to anti-reflux therapy. Food allergy is currently recognized as the main immunological cause of EE; recent evidence suggests an etiological role for inhalant allergens. The presence of EE appears to be associated with other atopic illnesses. Objectives: To report the sensitization profile of both food and inhalant allergens in our EE patient cohort in relation to age, and to profile the prevalence of other allergic conditions in patients with EE. Method: The study prospectively analyzed allergen sensitization profiles using skin prick tests to common food allergens and inhalant allergens in 45 children with EE. Patch testing to common food allergens was performed on 33 patients in the same cohort. Comorbidity of atopic eczema, asthma, allergic rhinitis and anaphylaxis were obtained from patient history. Results: Younger patients with EE showed more IgE and patch sensitization to foods while older patients showed greater IgE sensitization to inhalant allergens. The prevalence of atopic eczema, allergic rhinitis and asthma was significantly increased in our EE cohort compared with the general Australian population. A total of 24% of our cohort of patients with EE had a history of anaphylaxis. Conclusion: In children with EE, the sensitization to inhalant allergens increases with age, particularly after 4 years. Also, specific enquiry about severe food reactions in patients presenting with EE is strongly recommended as it appears this patient group has a high incidence of anaphylaxis
Keyword(s)	Allergy Immunology aeroallergens anaphylaxis eosinophilic esophagitis food allergens Children Anaphylaxis Pollen