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Identification of Food Sensitivity in Adult Eosinophilic Esophagitis Patients Lacks Clinical Utility
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Ashleigh A. Olson, MD, David M. Manthei, Chloe Kim, M.D., Michael D. Evans, MS, Sameer K. Mathur, MD PhD FAAAAI
Rationale: Evaluation of IgE mediated food sensitivity is frequently performed for EoE patients. However, the clinical relevance of identifying IgE mediated sensitivity to foods is not clear. We sought to determine whether EoE patients with food sensitivity represent a phenotype of EoE with distinct clinical features. 

Methods: An IRB approved retrospective chart review identified 724 adults with a diagnosis of EoE seen at the University of Wisconsin Hospital and Clinics through the year 2013. Individual patient charts were reviewed to capture disease severity, endoscopy results, pathology results, allergy testing, medical management and patient outcomes. 

Results: 257 out of the 724 adult patients met clinical criteria for EoE and were evaluated in the allergy clinic. 93% of those patients had skin prick testing and/or serum IgE done to foods.  The prevalence of food sensitization to at least one food was 53%, with peanut being the most common food sensitivity (52%), followed by soy (36%).  Patients with food sensitivity were more likely to report concomitant asthma, allergic rhinitis, eczema and/or food allergy compared to non-food sensitive patients.  Other clinical characteristics, including symptoms, disease severity, endoscopic findings, peripheral eosinophilia, and patient reported outcomes did not differ between food sensitive and non-food sensitive patients. Additionally, there was no significant difference in outcomes for food sensitive patients treated with food avoidance compared to food sensitive patients treated without food avoidance.

Conclusions: Food sensitive adult EoE patients are not phenotypically different than non-food sensitive patients.  We did not observe any clinical utility for identifying food sensitivity in adult EoE patients.