Roy-Ghanta Sumita, Larosa David F, Katzka David A
Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Clin Gastroenterol Hepatol. 2008 May;6(5):531-5. doi: 10.1016/j.cgh.2007.12.045. Epub 2008 Mar 4.
BACKGROUND & AIMS: The association of sensitization to food allergens, atopic disorders, and eosinophilic esophagitis (EE) is well known in children, but not in adults. Our purpose was to identify the spectrum of specific allergic sensitivities to environmental and food allergens within a series of adult patients with EE.
The case series consisted of 23 adult patients with biopsy-proven EE referred for allergy evaluation at an academic clinic. All patients had data that included serum measurement of specific immunoglobulin (Ig)E antibodies to common foods and spices. Patients diagnosed with allergic rhinitis had a relevant clinical history of respiratory allergy and evidence of specific IgE to environmental aeroallergens.
The series consisted of 16 men and 7 women with a median age of 34 years (range, 18-57 y). Eighteen of 23 had an atopic diathesis, allergic rhinitis being the most common. Seventeen of 21 patients were polysensitized to several different environmental allergens, and 19 of 23 (82%) had serum IgE specific for one or more food-associated allergens (median, 5 foods), with wheat, tomato, carrot, and onion identified most commonly. The preponderance of environmental and food allergy was similar across all age groups and did not favor younger adults.
By using objective measures, our series confirms the high degree of atopy in adults with EE, similar to that seen in the pediatric population. These patients tend to be polysensitized to several environmental allergens, and the profiles of serum IgE specific for food allergens suggest that sensitization may partly be a response to inhaled allergens.
食物过敏原致敏、特应性疾病和嗜酸性食管炎（EE）之间的关联在儿童中已广为人知，但在成人中却并非如此。我们的目的是确定一系列成年EE患者对环境和食物过敏原的特异性过敏敏感性谱。
该病例系列包括23例经活检证实为EE的成年患者，他们被转诊至一家学术诊所进行过敏评估。所有患者的数据均包括血清中针对常见食物和香料的特异性免疫球蛋白（Ig）E抗体检测。被诊断为过敏性鼻炎的患者有相关的呼吸道过敏临床病史以及针对环境空气过敏原的特异性IgE证据。
该系列包括16名男性和7名女性，中位年龄为34岁（范围18 - 57岁）。23例中有18例有特应性素质，其中过敏性鼻炎最为常见。21例患者中有17例对几种不同的环境过敏原多敏，23例中有19例（82%）血清IgE针对一种或多种食物相关过敏原（中位值为5种食物），最常见的是小麦、番茄、胡萝卜和洋葱。所有年龄组中环境和食物过敏的优势情况相似，并不偏向于年轻成年人。
通过客观测量，我们的系列研究证实成年EE患者的特应性程度很高，与儿科人群相似。这些患者往往对几种环境过敏原多敏，食物过敏原特异性血清IgE谱表明致敏可能部分是对吸入性过敏原的反应。
