CASE REPORTSSuccessful Food Elimination Therapy in Adult Eosinophilic Esophagitis Not All Patients are the SameGonzález-Cervera, Jesús MD*; Angueira, Teresa MD†; Rodriguez-Domínguez, Benito MD*; Arias, Ángel BSc‡; Yagüe-Compadre, José Luis MD§; Lucendo, Alfredo J. MD, PhD, FEBG† Author Information *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: [email protected]). Journal of Clinical Gastroenterology: November/December 2012 - Volume 46 - Issue 10 - p 855-858 doi: 10.1097/MCG.0b013e3182432259 Buy Metrics Abstract 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. © 2012 Lippincott Williams & Wilkins, Inc.