A recent review article (Clin Gastroenterol Hepatol 2014; 12: 1216-23) summarizes the potential role of allergy testing for eosinophilic esophagitis (EoE).
The article summarizes the potential ways to use various allergy testing and reviews the literature on its effectiveness. The article notes a couple of key points:
- Overall, using skin prick testing (SPT) and atopy patch testing (APT), allergy testing has not proved more reliable then empirically administering a 6-food elimination diet. Thus, “the issue remains whether food allergy testing provides a useful tool in EoE.” However, targeted testing-based diets (especially in children) may require elimination of fewer foods.
- “Serum IgE food-specific IgE panels should not be used for EoE.” “Testing for foods, especially IgE testing, leads to recognition of food sensitizations that may not be clinically relevant and that on elimination, could result in the loss of tolerance to the food.”
- Testing for milk allergy is noted have a high false negative rate.
- IgG based testing is not recommended. In fact, IgG immunoglobulins are “associated with tolerance rather than allergy.”
- “Only 8% of children will become tolerant to all foods that cause their EoE.”
Bottomline: While foods commonly triggers EoE, the tests to identify these foods are far from perfect. I find that families are quite uninformed about the frequent lack of correlation between allergy testing and true EoE triggers.
Related blog posts:
- Systemic Review of Dietary Treatments for Eosinophilic …
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- SFED works for EoE! | gutsandgrowth
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Summary of article: GI & Hepatology News August 2014 Role of Allergy Testing in EoE
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