Antón Remírez Judith, Escudero Rosario, Cáceres Oscar, Fernández-Benítez Margarita
Department of Allergology and Clinical Immunology, Clínica Universitaria, Facultad de Medicina, Universidad de Navarra, Pamplona, Spain.
Allergol Immunopathol (Madr). 2006 Mar-Apr;34(2):79-81. doi: 10.1157/13086753.
Esophagitis is an increasingly diagnosed disease. Patients with gastroesophagic reflux, dysphagia, vomiting or abdominal pain, with a torpid response to the treatment, could be suffering from it.
A 37 year-old male patient with background of gastroesophagic reflux and dysphagia for solids since 2002, self-limited diarrhea episodes and intolerance to alcoholic drinks due to epigastric pain. Skin prick tests, specific IgE, histamine release test and basophil activation test were carried out.
Skin prick test to the usual allergens with negative result; prick-prick tests to egg white and yolk, milk and apple with positive result to egg white; total serum IgE within normal levels, specific IgE to egg white with positive result; histamine release test (HRT) and basophil activation test (BAT) with positive result to egg white and yolk.
The patient was diagnosed eosinophilic esophagitis. The commercial food extracts have a great variability in their allergenic composition, which could result in false negative results in the prick test. Prick-prick with the natural food is a more sensitive technique than prick in the diagnosis of food allergy. There are other useful in vitro techniques, apart from specific IgE, in the diagnosis of food allergy. In our case, an exclusion diet of the involved food was more effective than other treatments for remission of the symptoms.
食管炎是一种诊断率日益上升的疾病。患有胃食管反流、吞咽困难、呕吐或腹痛且治疗反应迟缓的患者可能患有此病。
一名37岁男性患者，自2002年起有胃食管反流和固体食物吞咽困难病史，有自限性腹泻发作且因上腹部疼痛对酒精饮料不耐受。进行了皮肤点刺试验、特异性IgE检测、组胺释放试验和嗜碱性粒细胞活化试验。
对常见变应原的皮肤点刺试验结果为阴性；对蛋清和蛋黄、牛奶和苹果进行点刺-点刺试验，蛋清结果为阳性；血清总IgE在正常水平，蛋清特异性IgE结果为阳性；组胺释放试验（HRT）和嗜碱性粒细胞活化试验（BAT）对蛋清和蛋黄结果为阳性。
该患者被诊断为嗜酸性食管炎。市售食物提取物的变应原成分差异很大，这可能导致点刺试验出现假阴性结果。用天然食物进行点刺-点刺试验在食物过敏诊断中比点刺试验更敏感。除特异性IgE外，还有其他有用的体外技术可用于食物过敏的诊断。在我们的病例中，排除相关食物的饮食对缓解症状比其他治疗更有效。
