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Diagnostic yield of allergy testing in Pediatric Eosinophilic Esophagitis: a 10 year experience at a tertiary care centre

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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 However, the natural history of EoE suggests that this condition is chronic and may recur when corticosteroids are withdrawn...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... 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... Six patients (7%) had a first degree family member diagnosed with EoE... Patients who reported a history of food allergy were significantly more likely to present with a food bolus impaction at diagnosis (p=0.035, OR=3.056)... Sixty-nine patients underwent allergy testing as part of a standard EoE workup, of which, 60 (87.0%) had a positive test result... 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.

No MeSH data available.


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N=69 underwent skin prick testing
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Figure 2: N=69 underwent skin prick testing

Mentions: A total of 96 cases were identified. The median age at diagnosis was 13.2 years (IQR=8.6-15.7), and 72 of the identified cases were male (74.2%). Seventy-four of 91 (81%) and 62 of 79 (78%) patients with data available reported a history of personal and family atopy, respectively. Six patients (7%) had a first degree family member diagnosed with EoE. Patients who reported a history of food allergy were significantly more likely to present with a food bolus impaction at diagnosis (p=0.035, OR=3.056). Sixty-nine patients underwent allergy testing as part of a standard EoE workup, of which, 60 (87.0%) had a positive test result. Ten (14.5%) patients who had identifiable allergies were positive only to environmental allergens. The top identified food and environmental allergens were recorded by allergy test type (Figs 1, 2, 3, 4).


Diagnostic yield of allergy testing in Pediatric Eosinophilic Esophagitis: a 10 year experience at a tertiary care centre
N=69 underwent skin prick testing
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4126049&req=5

Figure 2: N=69 underwent skin prick testing
Mentions: A total of 96 cases were identified. The median age at diagnosis was 13.2 years (IQR=8.6-15.7), and 72 of the identified cases were male (74.2%). Seventy-four of 91 (81%) and 62 of 79 (78%) patients with data available reported a history of personal and family atopy, respectively. Six patients (7%) had a first degree family member diagnosed with EoE. Patients who reported a history of food allergy were significantly more likely to present with a food bolus impaction at diagnosis (p=0.035, OR=3.056). Sixty-nine patients underwent allergy testing as part of a standard EoE workup, of which, 60 (87.0%) had a positive test result. Ten (14.5%) patients who had identifiable allergies were positive only to environmental allergens. The top identified food and environmental allergens were recorded by allergy test type (Figs 1, 2, 3, 4).

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

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 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... 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... Six patients (7%) had a first degree family member diagnosed with EoE... Patients who reported a history of food allergy were significantly more likely to present with a food bolus impaction at diagnosis (p=0.035, OR=3.056)... Sixty-nine patients underwent allergy testing as part of a standard EoE workup, of which, 60 (87.0%) had a positive test result... 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.

No MeSH data available.


Related in: MedlinePlus