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 Marijn Warners and colleagues 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 (controls).
The team performed a second endoscopy was performed after 24 hours to evaluate delayed responses.
|5 of the 8 patients with eosinophilic esophagitis had evidence for an acute response|
The researchers found that 5 of the 8 patients with eosinophilic esophagitis had evidence for an acute response, and 2 other patients had a delayed wheal or flare reaction.
No responses were observed in controls.
Dr Marijn's team concludes, "We conclude that 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."