Skin tests and measurement of serum levels of immunoglobulin E do not accurately identify foods for elimination from the diets of patients with eosinophilic esophagitis.
Dr Albert Bredenoord and colleagues from the Netherlands investigated whether an esophageal prick test, in which the esophageal mucosa is challenged by local injection of allergen extracts, could identify individuals with esophageal sensitization.
During endoscopy, 6 allergens were injected in the esophagus of 8 patients with eosinophilic esophagitis, and 3 patients without eosinophilic esophagitis.
|5 of the 8 patients with eosinophilic esophagitis had evidence for an acute response|
A second endoscopy was performed after 24 hours to evaluate delayed responses.
The research team noted that 5 of the 8 patients with eosinophilic esophagitis had evidence for an acute response.
The researchers found that 2 other patients had a delayed wheal or flare reaction.
No responses were observed in controls.
Dr Bredenoord's team comments, "Esophageal mucosal food allergen injections induce acute and/or delayed responses in patients with eosinophilic esophagitis but not controls."
"The esophageal prick test deserves further exploration because it may guide elimination diets."