Eosinophilic Esophagitis (EoE) is a combined IgE mediated immediate hypersensitivity and Type IV hypersensitivity reaction for which the evaluation includes skin prick test (SPT) and/or specific IgE (sIgE); and patch test (PT) respectively. We compared the positivity of these tests to foods singly or in combination in pediatric patients with biopsy proven EoE.
We conducted a retrospective chart study of 17 pediatric patients with biopsy proven EoE. Data analyzed include PT, SPT, and sIgE levels to 25 specific foods (425 total patches placed).
Of 17 patients, 9 were female and 13 had a history of atopy (asthma, allergic rhinitis and/or atopic dermatitis). Sixteen of 25 foods were positive on PT and 9 were negative. Of those with a positive PT, 3 (19%) (wheat, white potato and peanut) were positive in both PT and SPT and/or sIgE; and 13 (81%) were SPT negative with normal sIgE levels. Four foods (barley, green beans, squash, and lamb) were negative in all testing modalities used.
The majority of foods that were positive on PT (81%) were negative to SPT or sIgE. When used in combination PT, SPT, and sIgE may yield more positive results than individually. Certain foods are more likely to have negative results in all modalities of testing and may not have utility in identifying food hypersensitivity in pediatric EoE.