Serum Immunoglobulin E (IgE) Measurement and Detection of Food Allergy in Pediatric Patients With Eosinophilic Esophagitis

PEDIATRICS ◽  
2011 ◽  
Vol 128 (Supplement 3) ◽  
pp. S109.2-S110
Author(s):  
Vivian Hernandez-Trujillo
Keyword(s):  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Pediatric Patients ◽  
Immunoglobulin E ◽  
Serum Immunoglobulin

scholarly journals Dietary Management of Eosinophilic Esophagitis: Tailoring the Approach

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1630
Author(s):  
Pierfrancesco Visaggi ◽  
Lucia Mariani ◽  
Veronica Pardi ◽  
Emma Maria Rosi ◽  
Camilla Pugno ◽  
...  
Keyword(s):  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Immunoglobulin E ◽  
Wheat Gluten ◽  
Skin Tests ◽  
Dietary Therapy ◽  
Dietary Management ◽  
High Power Field ◽  
Advantages And Disadvantages

Eosinophilic esophagitis (EoE) is a unique form of non-immunoglobulin E-mediated food allergy, restricted to the esophagus, characterized by esophageal eosinophil-predominant inflammation and dysfunction. The diagnosis requires an esophago-gastroduodenoscopy with esophageal biopsies demonstrating active eosinophilic inflammation with 15 or more eosinophils/high-power field, following the exclusion of alternative causes of eosinophilia. Food allergens trigger the disease, withdairy/milk, wheat/gluten, egg, soy/legumes, and seafood the most common. Therapeutic strategies comprise dietary restrictions, proton pump inhibitors, topical corticosteroids, biologic agents, and esophageal dilation when strictures are present. However, avoidance of trigger foods remains the only option targeting the cause, and not the effect, of the disease. Because EoE relapses when treatment is withdrawn, dietary therapy offers a long-term, drug-free alternative to patients who wish to remain off drugs and still be in remission. There are currently multiple dietary management strategies to choose from, each having its specific efficacy, advantages, and disadvantages that both clinicians and patients should acknowledge. In addition, dietary regimens should be tailored around each individual patient to increase the chance of tolerability and long-term adherence. In general, liquid elemental diets devoid of antigens and elimination diets restricting causative foods are valuable options. Designing diets on the basis of food allergy skin tests results is not reliable and should be avoided. This review summarizes the most recent knowledge regarding the clinical use of dietary measures in EoE. We discussed endpoints, rationale, advantages and disadvantages, and tailoring of diets, as well as currently available dietary regimens for EoE.

scholarly journals Updates on Food Allergy, Increasingly Prevalent Challenge

2018 ◽  
Vol 10 (3) ◽  
pp. 152
Author(s):  
Tonny Tanus ◽  
Sunny Wangko
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Immunoglobulin E ◽  
Pediatric Population ◽  
Food Allergies ◽  
Food Protein ◽  
Safety Issues ◽  
Ige Mediated ◽  
Allergic Disorders

Abstrak: Prevalensi alergi makanan makin meningkat di seluruh dunia dan mengenai semua usia. Keparahan dan kompleksitas penyakit juga meningkat terlebih pada populasi anak. Terdapat beberapa jenis reaksi alergi yang dibahas: immunoglobulin E (IgE) mediated allergies and anaphylaxis, food triggered atopic dermatitis, eosinophilic esophagitis, dan non IgE mediated gastrointestinal food allergic disorders seperti food protein induced enterocolitis syndrome (FPIEs). Tes alergi, baik melalui kulit maupun IgE yang telah dikerjakan sekian lama masih dibebani dengan hasil positif palsu dan negatif palsu yang bermakna dengan manfaat terbatas pada beberapa alergi makanan. Selain menghindari, tidak terdapat terapi yang ampuh untuk alergi makanan. Berbagai imunoterapi telah dipelajari melalui jalur, subkutan, epikutan, oral dan sublingual yang hanya menghasilkan desensitisasi sementara dan dibebani dengan berbagai isu mengenai keamanannya. Agen biologik yang menghambat sitokin/interleukin (IL) dan molekul pada reaksi alergi makanan tampaknya merupakan pilihan yang menjanjikan. Anti IgE telah dipergunakan pada asma dan urtikaria kronis. Anti IL-4 dan IL-13 yang menghambat produksi IgE diindikasikan untuk dermatitis atopik. Anti eosinofil anti IL-5 berhasil menurunkan eksaserbasi asma. Berbagai agen biologik telah dipelajari untuk berbagai kondisi alergik dan imunologik, tetapi efektivitas dan kepraktisan terapi yang mahal ini untuk alergi makanan masih menjadi tanda tanya.Kata kunci: alergi makanan, reaksi alergi, terapi alergi makananAbstract: Food allergies have been increasing in prevalence for years affecting all ages. Disease severity and complexity have also increased, especially in the pediatric population. There are several types of reactions including: immunoglobulin-E (IgE) mediated allergies and anaphylaxis, food-triggered atopic dermatitis, eosinophilic esophagitis, and non IgE mediated gastrointestinal food allergic disorders such as FPIEs. Though allergy testing has been around for years, both skin and IgE testing are burdened by significant false positives and negatives, and are only useful in some food allergies. Avoidance is the sole therapy for food allergy. A variety of immunotherapies have been studied; subcutaneous, epicutaneous, oral, and sublingual. At best they only produce a temporary state of desensitization and have many safety issues. Examples of biologicals which block critical cytokines/interleukins (IL) in allergic conditions are Anti IgE, anti IL-4 and IL-13, and Anti eosinophils, Anti IL-5. Other biologicals are being studied for allergic conditions, but whether these expensive future treatments will be proven effective and practical in food allergy is unknown.Keywords: food allergy, allergic reaction, food allergy therapy

scholarly journals Serum IgE measurement and detection of food allergy in pediatric patients with eosinophilic esophagitis

2010 ◽  
Vol 104 (6) ◽  
pp. 496-502 ◽  
Author(s):  
Elizabeth A. Erwin ◽  
Hayley R. James ◽  
Heather M. Gutekunst ◽  
John M. Russo ◽  
Kelly J. Kelleher ◽  
...  
Keyword(s):  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Pediatric Patients ◽  
Serum Ige

scholarly journals Propofol Use in Pediatric Patients With Food Allergy and Eosinophilic Esophagitis

2017 ◽  
Vol 64 (4) ◽  
pp. 546-549 ◽  
Author(s):  
Pooja Mehta ◽  
Shikha S. Sundaram ◽  
Glenn T. Furuta ◽  
Zhaoxing Pan ◽  
Dan Atkins ◽  
...  
Keyword(s):  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Pediatric Patients

Clinical Characteristics of Eosinophilic Esophagitis in Children

2005 ◽  
Vol 114 (11) ◽  
pp. 827-833 ◽  
Author(s):  
Eileen H. Dauer ◽  
Deborah K. Freese ◽  
Mounif El-Youssef ◽  
Dana M. Thompson
Keyword(s):  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Immunoglobulin E ◽  
Clinical Suspicion ◽  
Aerodigestive Tract ◽  
Food Impaction ◽  
Laboratory Findings

Objectives: The role of eosinophilic esophagitis (EE) in aerodigestive tract disorders in children is underestimated and overlooked, primarily because of a lack of understanding of this disorder by otolaryngologists. We sought to better characterize the clinical presentation of EE in order to increase awareness among otolaryngologists. Methods: We retrospectively reviewed 71 children with biopsy-proven EE to determine the most common symptoms and laboratory findings that should increase the clinical suspicion of EE. Results: Dysphagia, food impaction, and emesis were the most common symptoms in children with EE. Asthma was the most common airway diagnosis. Rhinosinusitis was the most common otolaryngological diagnosis. Food allergy was present in 60% of the children tested. Eighty-three percent of the children with elevated immunoglobulin E levels had thick linear streaking or patchy white exudate of the esophagus seen on esophagoscopy. Other major medical comorbidities existed in more than half of the children with EE, of which psychiatric disorders and other disorders of the aerodigestive tract were the most common. Conclusions: Eosinophilic esophagitis may contribute to treatment failure in patients with common and complicated aerodigestive tract disorders. To encourage clinicians to avoid overlooking the diagnosis, we present an evaluative algorithm to increase the suspicion of this entity.

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