Food, drug, insect sting allergy, and anaphylaxisIdentification of causative foods in children with eosinophilic esophagitis treated with an elimination diet
Section snippets
Center for Pediatric Eosinophilic Disorders database
The study was approved by the Children's Hospital of Philadelphia's Institutional Review Board. All patients seen in the Center for Pediatric Eosinophilic Disorders and any patient seen with eosinophilic esophagitis, eosinophilic gastroenteritis, and eosinophilic colitis were entered into the database. Data were entered in a prospective manner, and the data analysis was performed retrospectively.
Definition of EoE
Patients were given a diagnosis of EoE per the most recent 2011 consensus document.1 The maximal
Demographics
One thousand one hundred eighty-seven patients were included in the Center for Pediatric Eosinophilic Disorders database at the Children's Hospital of Philadelphia. All patients with eosinophilic gastrointestinal disease were included, as were patients referred for second opinions with esophageal eosinophilia. Forty-eight patients with eosinophilic gastroenteritis, 7 patients with eosinophilic colitis, and 191 patients with proton pump inhibitor–responsive EoE were excluded (Fig 1). Among the
Discussion
We were able to identity definitive foods in 319 patients from the entire 793-patient cohort. The remaining population was divided into 2 groups: 151 patients on elemental diets because of their age or having symptoms/biopsy changes when introducing simple fruits and vegetables. In these patients an elemental diet led to resolution in greater than 95% of the patients (similar to previous published studies).15 For the second group of 245 patients, dietary restrictions were successful, with
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Institutional support was from the Department of Pediatrics, the Children's Hospital of Philadelphia, and the Joint Center for Gastroenterology and Nutrition of the Children's Hospital of Philadelphia at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia Food Allergy Family Research Fund.
Disclosure of potential conflict of interest: J. M. Spergel is on the American Academy of Allergy, Asthma & Immunology Board; is on the American Partnership for Eosinophilic Disorders (APFED) Medical Advisory Board; is a consultant for DBV and Danone; has provided expert testimony in malpractice cases; has received research support from the Department of Defense, the National Institutes of Health (NIH), APFED, TIGERS, Ception, and Nutricia; has received lecture fees from the California Pediatrics Society, the UMDNJ Medical School, the Florida Allergy Society, the NJ Allergy Society, MEI, and Abbott; has received payment for the development of educational presentations from MEI; and has stock options in DBV. T. F. Brown-Whitehorn has received research support from DBV Technologies and has received payment for manuscript preparation for Current Problems in pediatric and adolescent health care. A. Cianferoni has received research support from the NIH. M. Shuker has received lecture fees and payment for the development of educational presentations from Abbott Nutrition and has received payment for manuscript preparation and compensation for a Food Allergy and Anaphylaxis Network newsletter from Nutricia North America. C. A. Liacouras has stock options in Ception. The rest of the authors declare that they have no relevant conflicts of interest.