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Successful Treatment of Eosinophilic Gastroenteritis with a Multiple-Food Elimination Diet
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Yoshiyuki Yamada, M.D., Ph.D., Yuka Isoda, Akira Nishi, M.D., Yuko Jinbo, Satoru Watanabe, Masahiko Kato, MD, PhD FAAAAI
Rationale: Dietary restriction therapies for eosinophilic gastroenteritis (EGE) have been shown to be effective in some studies. We analyzed the effectiveness of a multiple-food elimination diet (MFED), an empiric diet preferentially devoid of the six most common food allergens—milk, soy, egg, wheat, peanuts/tree nuts, and shellfish/fish (6-FED)—and other the patient’s historically causative foods for the treatment of EGE.

Methods: Three patients with EGE who were diagnosed on the basis of gastrointestinal symptoms and eosinophil infiltration of the gastrointestinal mucosa (≥20 eosinophils/high-power field) and were treated with a MFED (for a total of four times) followed by reintroduction of those eliminated foods without systemic steroids at our hospital between 2010 and 2014 were included. Clinical data, including imaging and histological findings, and eosinophil, albumin, immunoglobulin G (IgG), and hemoglobin levels before and after the MFED were retrospectively reviewed and compared.

Results: Before the MFED, all patients had a low serum IgG level. A low albumin level and a low hemoglobin level were observed in one patient each. All patients showed an improvement of clinical symptoms and imaging or histological findings; a decrease in the eosinophil level; and an increase in the albumin, IgG, and hemoglobin levels after the MFED. The causative foods identified in the reintroduction phase were cow’s milk and wheat in two patients and soybean and hen’s eggs in one patient each.

Conclusions: The MFED may be a promising alternative treatment to improve clinical findings and laboratory data in patients with EGE.