Propofol administration is safe in adult eosinophilic esophagitis patients sensitized to egg, soy, or peanut.
BACKGROUND
Sedation might improve tolerability and adherence to endoscopic procedures in patients with eosinophilic esophagitis (EoE). Propofol administration is often contraindicated in patients with hypersensitivity to egg, soy, or peanut.


OBJECTIVE
To investigate the safety of propofol administration for procedural sedation in EoE patients sensitized/allergic to egg, soy, peanut.


METHODS
A retrospective observational study in adult EoE patients undergoing esophagogastroduodenoscopy with propofol sedation was conducted between January 2009 and March 2013. Food-specific serum IgE and skin prick tests for egg, soy, peanut, and cross-reactant foods were performed in all patients.


RESULTS
Sixty EoE adult patients, mostly on food elimination diets (91%), were evaluated (age: 28 years (14-56), male gender (90%)). Atopy was present in 88% of patients, being the most prevalent comorbidities rhinoconjunctivitis (78%) and asthma (67%). Fifty-two patients (86%) were sensitized to either egg, soy, or peanut. Eighteen patients (28%) had a history of allergic reactions to egg, legumes, and nuts and strictly avoided these foods. A total of 404 upper endoscopies were performed under propofol sedation. No allergic adverse events were reported, except a transient bronchospasm after orotracheal intubation in an asthmatic adolescent receiving multiple drugs for anesthesia, in whom no sensitization to either propofol or its lipid vehicle was confirmed.


CONCLUSIONS
Propofol was safely administered for procedural sedation in a large series of adult EoE patients multisensitized to egg, soy, peanut, showing one-third clinical allergy to these foods.
Department of Gastroenterology, Hospital San Pedro de Alcantara, Caceres, Spain.
J
J
Molina-Infante
A
A
Arias
D
D
Vara-Brenes
R
R
Prados-Manzano
J
J
Gonzalez-Cervera
M
M
Alvarado-Arenas
A J
AJ
Lucendo
D000293:Adolescent; D000328:Adult; D010367:Arachis / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000150:complications* / Q000276:immunology*; D004531:Eggs / Q000009:adverse effects; D057765:Eosinophilic Esophagitis / Q000150:complications* / Q000276:immunology; D005260:Female; D005502:Food / Q000009:adverse effects*; D005512:Food Hypersensitivity / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013025:Glycine max / Q000009:adverse effects; D055815:Young Adult
D006993:Hypnotics and Sedatives; D007073:Immunoglobulin E; D015742:Propofol
egg; eosinophilic esophagitis; peanut; propofol; soy