Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio 43205, USA.
Ann Allergy Asthma Immunol. 2010 Jun;104(6):496-502. doi: 10.1016/j.anai.2010.03.018.
Although associated allergies are common and the mechanism may include long-term exposure to allergens, measurement of serum specific IgE levels has not been studied in pediatric eosinophilic esophagitis (EE).
To compare the results of serum IgE testing, patch testing, and epicutaneous skin testing to measure allergic sensitization in pediatric patients with EE.
In a cross-sectional study of 53 pediatric patients with EE, relevant history was obtained by questionnaire, and patch testing to foods was performed. Food and inhalant sensitivities were also assessed using skin prick testing and serum specific IgE measurement. Streptavidin CAP was used to measure specific IgE to cross-reactive carbohydrate determinants and Helicobacter pylori.
The overall prevalence of food and inhalant sensitization was 80%, with higher total IgE levels in sensitized vs nonsensitized patients (median, 150 vs 13 IU/mL; P < .001). For foods, serum IgE measurement detected more positive results than did skin prick testing. Specific IgE to milk was most common (43%). Inhalants were implicated as frequently as were foods. In keeping with this, 32% of patients had a cluster of multiple sensitivities that included pollens, soy, grains, peanut, and tree nuts and had higher total IgE levels (P = .001). Patch test results were interpreted as positive in 39% of patients (rye, wheat, and soy were the most common).
Most, but not all, patients with EE are highly atopic individuals with frequent allergic sensitivities. Thus, serum IgE measurement of low-titer IgE antibody may be useful in identifying relevant food sensitivities and in distinguishing subgroups of patients with EE, making a more directed approach to food avoidance possible.
尽管相关过敏很常见，其机制可能包括长期暴露于过敏原，但尚未研究过血清特异性 IgE 水平在儿科嗜酸性食管炎 (EE) 中的变化。
比较血清 IgE 检测、斑贴试验和皮内皮肤试验在测量儿科 EE 患者过敏敏化中的结果。
在一项对 53 例儿科 EE 患者的横断面研究中，通过问卷调查获得相关病史，并进行食物斑贴试验。还使用皮肤点刺试验和血清特异性 IgE 测量来评估食物和吸入性敏感性。链霉亲和素 CAP 用于测量交叉反应性碳水化合物决定簇和幽门螺杆菌的特异性 IgE。
食物和吸入性致敏的总体患病率为 80%，致敏患者与非致敏患者的总 IgE 水平更高（中位数，150 vs 13 IU/mL；P <.001）。对于食物，血清 IgE 测量比皮肤点刺试验检测到更多的阳性结果。最常见的是对牛奶的特异性 IgE（43%）。吸入物与食物一样常见。同样，32%的患者有多个敏感性的集群，包括花粉、大豆、谷物、花生和坚果，且总 IgE 水平更高（P =.001）。39%的患者斑贴试验结果为阳性（黑麦、小麦和大豆最常见）。
大多数但不是所有的 EE 患者都是高敏个体，常有过敏敏感。因此，低滴度 IgE 抗体的血清 IgE 测量可能有助于识别相关的食物敏感性，并区分 EE 患者的亚组，从而可以更有针对性地避免食物。
