Allergy Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
Allergy Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
Allergol Immunopathol (Madr). 2020 Nov-Dec;48(6):576-581. doi: 10.1016/j.aller.2020.05.006. Epub 2020 Jul 13.
Eosinophilic esophagitis (EoE) is a chronic, local immune-mediated esophageal disease that has been on the increase lately. There is currently enough evidence to conclude that EoE is an allergic disorder triggered by food allergens, with cow's milk (CM) being the most frequent. Dietary intervention is the first-line approach. This study aimed to assess the clinical characteristics, the diagnostic method, and the prognosis of patients whose culprit food was CM, as opposed to other triggers.
Children with EoE evaluated in our pediatric Allergy Department were retrospectively studied from 2004 to 2017. We collected clinical variables, diagnostic protocol, treatment, and follow-up data. We compared patients whose culprit food was CM and patients with EoE due to other causative agents.
We analyzed 31 children with EoE and found the causative food to be cow's milk in 14 (45%). Clinical characteristics were similar in patients with EoE due to milk or any other cause. Eight of 14 patients with milk-induced EoE (57.14%) presented positive skin prick test results against cow's milk. All patients had positive IgE against cow's milk. None of the patients had any other food as the trigger. The median follow-up was 2.68 years (6 months to 9 years) with initial remission of 100%.
Testing-based elimination diets effectively treated all of the patients with milk-induced EoE. The advantage of this diagnostic protocol is that it required a mean of only two foods to be tested, significantly smaller number than in empiric diets.
嗜酸性食管炎（EoE）是一种慢性、局部免疫介导的食管疾病，近来发病率有所上升。目前已有足够的证据表明，EoE 是一种由食物过敏原引发的过敏疾病，其中以牛奶（CM）最为常见。饮食干预是首选方法。本研究旨在评估以牛奶为致病食物的患者的临床特征、诊断方法和预后，与其他触发因素相比。
我们回顾性研究了 2004 年至 2017 年在我院儿科过敏科就诊的嗜酸细胞性食管炎患儿。收集了临床变量、诊断方案、治疗和随访数据。比较了以牛奶为致病食物和以其他致病因素引起的 EoE 患者。
我们分析了 31 例嗜酸细胞性食管炎患儿，发现 14 例（45%）的致病食物为牛奶。因牛奶或其他原因引起的 EoE 患者的临床特征相似。14 例牛奶诱导性 EoE 患者中有 8 例（57.14%）对牛奶有阳性皮试结果。所有患者对牛奶均有阳性 IgE 反应。无患者有其他食物作为触发因素。中位随访时间为 2.68 年（6 个月至 9 年），初始缓解率为 100%。
基于检测的消除饮食有效地治疗了所有牛奶诱导性 EoE 患者。这种诊断方案的优点是只需要测试两种食物，比经验性饮食明显少。
