Aeroallergen, Food and Panallergen Sensitization Patterns in Eosinophilic Esophagitis Patients
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Mary Beth Hogan, MD, FAAAAI, Vonita Chawla, Rebecca Scherr, Gayle Allenback, Alex Wonnaparhown, Nevin W. Wilson, MD FAAAAI


Eosinophilic Esophagitis (EoE) has been etiologically associated with egg, milk, and wheat allergy.  Non-traditional allergens are being increasingly identified in EoE.  We aimed to identify sensitization patterns to aeroallergens and food, and associations with pan-allergens, in an EoE population.


A case-series analysis of skin test results from 66 EoE patients meeting IRB/study criteria was performed.  Associations between sensitization to pan-allergens, profilin/PR-10 and sensitization to aeroallergens and foods were determined via Chi-square tests. Entomophilous plant extracts (Locust; profilin, Alfalfa; PR-10, and non-native Ailanthus; profilin) were used as pan-allergen markers.


73 % of our EoE patients (aged 2-73 years; mean = 16 years; 56% male) were sensitized to both aeroallergens and food.  18% were sensitized solely to aeroallergens and 1.5% solely sensitized to food.  86.4 % patients were pansensitized (> 3 aeroallergens). Overall, patients were sensitized to an average of 20.4 (SD=14.9) aeroallergens and 6.3 (SD=6.5) foods.  Sensitization to egg (12/60, 20%), milk (8/62, 13%) and wheat (4/58, 7%) was less than anticipated, and sensitization to unique, pan-allergen containing foods: mustard (14/36, 39%), sunflower (15/25, 60%), garlic (12/45, 27%), and corn (12/46, 26%) was observed.  Sensitization to unusual foods, along with legumes and tree nuts, was significantly associated with sensitization to PR-10 (p<0.05) and profilin pan-allergen markers (p<0.05).


Novel findings in our EoE population included: 86.4% of patients were pansensitized to aeroallergens and increased sensitization to unique foods was associated with sensitization to pan-allergens.  Increased research into pan-allergen sensitization and cross reactivity to food maybe warranted in highly aeroallergen-pansensitized EoE patients.