Tests Identify Specific Food Allergens in Patients with Eosinophilic Esophagitis


Eosinophilic esophagitis (EE) is an increasingly diagnosed gastrointestinal disorder characterized by gastroesophageal reflux-like symptoms that do not respond to conventional treatments (such as proton pump inhibitors). In more severe cases, EE can lead to swallowing problems in children and failure to thrive in infants.

The specific food allergens that cause the symptoms of EE vary from person to person. In a recent letter to the Journal of Allergy and Clinical Immunology, Jonathan M. Spergel, M.D., Ph.D., Division of Allergy and Immunology, and associates report the predictive values for standard skin prick tests (SPTs) and atopy patch tests (APTs) in identifying the specific food allergens that produce the eosinophilic immune response in EE patients.

Among those foods most likely involved in the EE immune response are milk, wheat, corn, beef, egg, potato, chicken, soy, barley, oat and rice. By eliminating or reintroducing these foods in the diets of study participants, Dr. Spergel was able to determine the predictive values of the SPTs and APTs to identify which food or foods induced EE.

The investigators found that by combining SPT and APT evaluations, they could predict the specific food allergens of EE patients with an accuracy of 70 percent. Surprisingly, these tests did not accurately determine the contribution of milk to EE. The investigators therefore concluded that diet modifications based on the results of combined SPT and APT tests, along with the elimination of dietary milk, would be an appropriate test for identifying the specific food allergens that induce an individual's EE.