Should allergic sensitization be assessed in patients with eosinophilic gastrointestinal diseases under dietary treatment before reintroduction?

Primary eosinophilic gastrointestinal diseases (EGIDs) are defined by recurring or persistent gastrointestinal symptoms with histopathological eosinophilic inflammation, after excluding secondary causes. Food elimination diets (FEDs) are one of the main treatment options for primary EGIDs. Sensitization and immunoglobulin E (IgE)-mediated hypersensitivity reactions to eliminated foods after dietary restriction were reported in only a small number of patients with EGIDs. Here, a pediatric EGID patient was described who experienced anaphylaxis after the reintroduction of cow's milk post-FED. In addition, cases of primary EGID patients developing IgE-mediated hypersensitivity reactions to once-tolerated foods after elimination diets were reviewed.