Limited role of allergy testing in patients with eosinophilic gastrointestinal disorders.

Limited role of allergy testing in patients with eosinophilic gastrointestinal disorders.

Ishimura N, et al.

J Gastroenterol Hepatol. 2013 Mar 11.

BACKGROUND AND AIM: Allergies have been implicated in the pathogenesis of eosinophilic gastrointestinal disorders (EGID), though it remains unknown what type of allergen is closely associated with their development. The aim of this study is to investigate the possible involvement of food and/or aeroallergen factors in EGID.

METHODS: Eighteen patients with eosinophilic esophagitis (EoE), 23 with eosinophilic gastroenteritis (EGE), and 28 healthy volunteers were enrolled. The levels of total serum immunoglobulin E (IgE) and 33 different allergen-specific IgE antibodies, including those for 6 foods used in a standard EoE elimination diet, were determined in each subject. Serum antigen-specific IgE levels were measured using a chemiluminescence enzyme immunoassay with a multiple antigen simultaneous test 33 (MAST33(®) ). The expression patterns of specific antigens were compared among the groups.

RESULTS: The mean level of total IgE antibodies was significantly higher in patients with EGE (553.6±115.3 IU/ml) than the healthy volunteers (230.6±87.1 IU/ml). Two-thirds of all subjects had sensitivity to at least 1 inhaled antigen. In positive cases, allergies against multiple antigens were more frequently seen in the EoE and EGE patients. Japanese cedar and dust mite aeroallergens were more prevalent than food antigens.

CONCLUSIONS: Consistent with higher levels of serum total IgE antibodies, patients with EoE and EGE were frequently sensitized to several different allergens. Reactions to aeroallergens were more prevalent in these groups, though no particular antigen causing EoE and/or EGE was detected by measuring serum antigen specific IgE antibodies.

Source: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.


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