title: Successful food elimination therapy in adult eosinophilic esophagitis: not all patients are the same.
abstract: Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated, esophageal disease characterized by esophageal dysfunction and eosinophilic inflammation, manifested mainly as dysphagia and frequent food impaction. EoE is recognized into the spectrum of food allergy, but food sensitization studies used not to be efficient to identify the triggering food, because of what patients are frequently treated with topic steroids or even endoscopic esophageal dilation. Herein, we describe 3 adult patients-all suffering from EoE, but with different sensitization patterns-who were treated successfully with elimination diets. Allergy tests indicated no food sensitization for patient 1, but challenge with milk and wheat were positive. Food IgE-mediated allergies were found in patients 2 and 3; inflammation was resolved with food elimination. Lack of food allergy sensitization does not exclude the possibility of food allergies as a cause of EoE; elimination diets must therefore be considered as an effective diagnostic and treatment tool.
authors.affiliation: Department of Allergy, Hospital General de Tomelloso, Tomelloso, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: González-Cervera
authors.forename: Teresa
authors.initials: T
authors.lastname: Angueira
authors.forename: Benito
authors.initials: B
authors.lastname: Rodriguez-Domínguez
authors.forename: Angel
authors.initials: A
authors.lastname: Arias
authors.forename: José Luis
authors.initials: JL
authors.lastname: Yagüe-Compadre
authors.forename: Alfredo J
authors.initials: AJ
authors.lastname: Lucendo
mesh_terms: D000328:Adult; D003611:Dairy Products / Q000009:adverse effects; D002523:Edible Grain / Q000009:adverse effects; D057765:Eosinophilic Esophagitis / Q000178:diet therapy* / Q000276:immunology*; D007887:Fabaceae / Q000009:adverse effects; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications / Q000276:immunology*; D006801:Humans; D008297:Male