Department of Pediatrics, Division of Gastroenterology, Children's Hospital, King Fahad Medical City, P. O. Box 59046, 11525, Riyadh, Saudi Arabia,
J Gastroenterol. 2013 Nov;48(11):1205-12. doi: 10.1007/s00535-012-0741-6. Epub 2013 Jan 11.
To our knowledge, in Asia, data on utility of allergy tests in management of eosinophilic esophagitis are lacking. The objective of our study was to determine the role of allergy evaluation in management of Saudi children with eosinophilic esophagitis.
Children diagnosed as having eosinophilic esophagitis during the period from 2009 to 2012 were referred to an allergist for allergy evaluation. The allergy evaluation consisted of total IgE level, radio-allergosorbent assay, and skin prick test. Depending on the results of the allergy tests, a restricted or elemental diet was established. Swallowed fluticasone inhaler was prescribed to patients who rejected or failed to respond to the diet. Clinical, endoscopic, and histological evaluation was performed in 8 weeks to assess response.
Eighteen children with eosinophilic esophagitis were included (13 males; mean age 5 years, range 1-11). Sensitization to foods was demonstrated in 14 patients: 4 with a positive test for a single food (28.5%), 1 for 2 food allergens (7%), and 9 for ≥3 food allergens (64.5%). The most common food allergens were milk, soybean, wheat, egg, and nuts. Three young children out of the total 14 patients responded to elemental formula. Four of the 10 older children on the allergy testing guided-dietary restriction achieved partial remission and the remaining 6 did not respond. All 10 patients responded to a swallowed fluticasone inhaler.
Although food sensitizations in Saudi children with eosinophilic esophagitis are common, the allergy tests had limited predictive value for the response to dietary elimination.
据我们所知，亚洲缺乏有关过敏测试在嗜酸细胞性食管炎管理中的应用的数据。本研究的目的是确定过敏评估在沙特儿童嗜酸细胞性食管炎管理中的作用。
2009 年至 2012 年间，被诊断为嗜酸细胞性食管炎的患儿被转介给过敏专家进行过敏评估。过敏评估包括总 IgE 水平、放射过敏原吸附试验和皮肤点刺试验。根据过敏测试的结果，建立限制或元素饮食。对拒绝或对饮食无反应的患者开服吸入性氟替卡松。在 8 周内进行临床、内镜和组织学评估以评估反应。
共纳入 18 例嗜酸细胞性食管炎患儿（男 13 例；平均年龄 5 岁，范围 1-11 岁）。14 例患者对食物过敏：4 例对单一食物呈阳性（28.5%），1 例对 2 种食物过敏原呈阳性（7%），9 例对≥3 种食物过敏原呈阳性（64.5%）。最常见的食物过敏原是牛奶、大豆、小麦、鸡蛋和坚果。在 14 例总患儿中有 3 例年幼患儿对元素配方有反应。10 例接受过敏测试指导饮食限制的较大儿童中有 4 例部分缓解，其余 6 例无反应。10 例患儿均对吸入性氟替卡松有反应。
尽管沙特儿童嗜酸细胞性食管炎患者的食物过敏很常见，但过敏测试对饮食消除的反应预测价值有限。
