Hill David A, Dudley Jesse W, Spergel Jonathan M
Institute for Immunology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pa.
Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pa.
J Allergy Clin Immunol Pract. 2017 Mar-Apr;5(2):369-375. doi: 10.1016/j.jaip.2016.11.020. Epub 2016 Dec 30.
Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Recently, EoE has been identified in patients who underwent oral immunotherapy (OIT) for IgE-mediated food allergy, suggesting an association.
We sought to ascertain whether significant associations exist between IgE-mediated food allergies and EoE.
Using the analysis of electronic medical record data and manual chart review, we examined our subspecialty care network of 35,528 children and adolescents to identify and characterize patients with IgE-mediated and EoE food allergy. The most common food allergens were defined, and the prevalence of EoE in patients with IgE-mediated food allergy was determined. Logistic regression was used to measure the extent to which IgE-mediated food allergy to specific foods is associated with EoE.
The most common causes of EoE were milk, soy, egg, grains, and meats, an allergen pattern that is distinct from that of IgE-mediated food allergy. The prevalence of EoE in patients with IgE-mediated food allergy was higher than that reported in the general population (4.7% vs 0.04%). The distribution of IgE-mediated food allergens in patients with EoE was similar to that of the general population, and IgE-mediated allergy to egg (2.27; 1.91-2.64), milk (4.19; 3.52-4.97), or shellfish (1.55; 1.24-1.92) was significantly associated with an EoE diagnosis.
Our findings support a clinical association between these conditions that has implications for the management of children with food allergy, and particular relevance to patients undergoing OIT.
嗜酸性粒细胞性食管炎（EoE）是一种由食物过敏原引发的过敏性炎症性疾病，其特征为进行性食管功能障碍。最近，在接受针对IgE介导的食物过敏的口服免疫疗法（OIT）的患者中发现了EoE，提示二者存在关联。
我们试图确定IgE介导的食物过敏与EoE之间是否存在显著关联。
通过分析电子病历数据并人工查阅病历，我们对35528名儿童和青少年的专科护理网络进行了检查，以识别和描述患有IgE介导的食物过敏和EoE的患者。确定了最常见的食物过敏原，并测定了IgE介导的食物过敏患者中EoE的患病率。采用逻辑回归分析来衡量IgE介导的对特定食物的过敏与EoE的关联程度。
EoE最常见的病因是牛奶、大豆、鸡蛋、谷物和肉类，这种过敏原模式与IgE介导的食物过敏不同。IgE介导的食物过敏患者中EoE的患病率高于普通人群（4.7%对0.04%）。EoE患者中IgE介导的食物过敏原分布与普通人群相似，且IgE介导的对鸡蛋（2.27；1.91 - 2.64）、牛奶（4.19；3.52 - 4.97）或贝类（1.55；1.24 - 1.92）的过敏与EoE诊断显著相关。
我们的研究结果支持了这些疾病之间的临床关联，这对食物过敏儿童的管理具有重要意义，尤其与接受OIT的患者相关。
