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Successful Food Elimination Therapy in Adult Eosinophilic Esophagitis: Not All Patients are the Same

González-Cervera, Jesús MD*; Angueira, Teresa MD; Rodriguez-Domínguez, Benito MD*; Arias, Ángel BSc; Yagüe-Compadre, José Luis MD§; Lucendo, Alfredo J. MD, PhD, FEBG

doi: 10.1097/MCG.0b013e3182432259
Case Reports

Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated, esophageal disease characterized by esophageal dysfunction and eosinophilic inflammation, manifested mainly as dysphagia and frequent food impaction. EoE is recognized into the spectrum of food allergy, but food sensitization studies used not to be efficient to identify the triggering food, because of what patients are frequently treated with topic steroids or even endoscopic esophageal dilation. Herein, we describe 3 adult patients—all suffering from EoE, but with different sensitization patterns—who were treated successfully with elimination diets. Allergy tests indicated no food sensitization for patient 1, but challenge with milk and wheat were positive. Food IgE-mediated allergies were found in patients 2 and 3; inflammation was resolved with food elimination. Lack of food allergy sensitization does not exclude the possibility of food allergies as a cause of EoE; elimination diets must therefore be considered as an effective diagnostic and treatment tool.

*Departments of Allergy

Gastroenterology, Hospital General de Tomelloso, Tomelloso

Research Unit, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan

§Department of Pathology, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain

All authors contributed equally.

Supported by grant PI-2010/038 from FISCAM (Fundación Sociosanitaria de Castilla-La Mancha) to A.J.L.

The authors declare that they have nothing to disclose.

Reprints: Alfredo J. Lucendo, MD, PhD, FEBG, Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700 Tomelloso, Spain (e-mail: alucendo@vodafone.es).

© 2012 Lippincott Williams & Wilkins, Inc.