Aeroallergen and Food Sensitization Patterns in Adults with Eosinophilic Esophagitis
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Hoang Pham, MD 2016, BSc, BA, Zave H. Chad, MD FRCPC, Gordon L. Sussman, MD, FAAAAI, Jacques Hébert, MD, Charles W. Frankish, MD, Timothy Olynych, MD PhD, Amarjit Singh Cheema, MD, Jaime Del Carpio, MD, Rachel Harrison, BSc, Stephanie Santucci, RN, Paul Keith, MD FAAAAI, William H. Yang, MD
Rationale: Eosinophilic esophagitis (EoE) is diagnosed in patients with symptoms of esophageal dysfunction associated with predominant eosinophilic inflammation. Traditionally, attention has been directed toward IgE-mediated immediate-type food allergies, but environmental allergies may also play an important role. Th2 inflammation, implicated in EoE immunopathogenesis, is shared by many atopic conditions. The objective of this project was to contribute to the limited literature on the prevalence of environmental sensitization in adults with EoE.

Methods: We conducted a retrospective chart review from multiple allergy clinics in five Canadian cities for patients diagnosed with EoE. Demographics , skin prick tests (SPT), and treatment data were collected and reviewed.

Results: A total of 182 patients (male:female ratio of 2:1, p-value<0.01; 35±16 years) were diagnosed with EoE. Food sensitization was identified on SPTs in 47% of patients (peanuts=22%, tree nuts=27%, milk=12%, soy=12%, seafood=11%, egg=9%, vegetables=8%, wheat=5%, meat=6%, seeds=5%, fruits=4%, oats=2%). Environmental sensitization was detected in 85% of patients (tree=66%, grass=62%, ragweed=62%, dust mites=59%, cat=56%, mould=32%, dog=21%, cockroach=16%). Most patients had both environmental and food sensitization (43%) or environmental sensitization only (42%). Few had food sensitization only (8%) and some were negative to both food and environmental allergens (18%). Most patients were on PPIs (77%) or inhaled/swallowed corticosteroids (73%). 

Conclusions: Environmental allergies had a significantly higher prevalence than food sensitization. Comorbid atopic conditions like environmental allergies should be optimized, as there are trends in early clinical and basic research which suggest environmental allergies may contribute to EoE. The mechanism of EoE requires further study.