Demographic, clinical and allergological characteristics of Eosinophilic Esophagitis in a Spanish central region

Allergol Immunopathol (Madr). 2014 Sep-Oct;42(5):407-14. doi: 10.1016/j.aller.2013.04.004. Epub 2013 Jul 8.

Abstract

Background: Eosinophilic esophagitis (EoE) is a chronic inflammatory emerging disease of the oesophagus with immunoallergic aetiology. The allergens involved have not been clearly defined and may depend on the exposure of the population to aeroallergens or food antigens.

Materials and methods: Patients diagnosed with EoE between 2006 and 2011 were referred to our Allergy Section. Patch and skin prick tests (SPT) with aeroallergens and foods were performed, and total and specific IgE levels, eosinophil cationic protein levels and eosinophil count were determined.

Results: 43 patients were included. 36 (83.7%) were atopic. 29 patients presented choking, 19 dysphagia, 9 food impaction with urgent endoscopy, 4 chest pain, 1 isolated vomiting and 1 epigastric pain. 22 had two or more symptoms. The mean duration of symptoms was 3.73 years. Concomitant allergic diseases included rhinoconjunctivitis and/or asthma (31 patients), IgE food allergy (21 patients) and atopic dermatitis (3 patients). 32 (74%) were sensitized to aeroallergens, of which 90% were sensitized to pollens; 23 (54%) showed positive tests to foods and 12 of them (52%) to lipid transfer proteins (LTP). Of the 29 pollen-allergic patients, 15 (52%) were sensitized to plant foods and 10 (34.4%) to LTP.

Conclusions: Our findings support those reported in the literature: the disease is more common in men aged 30-40 years with at least a three-year history of symptoms of esophageal dysfunction, sensitized to pollens, the predominant aeroallergen in our area, but also to plant foods or panallergens. These results increase the evidence for an immunoallergic aetiology and can help us in the early diagnosis of EoE.

Keywords: Atopy; Eosinophilic esophagitis; Panallergens; Plants; Pollen.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cross-Sectional Studies
  • Eosinophilic Esophagitis / complications
  • Eosinophilic Esophagitis / immunology*
  • Female
  • Food Hypersensitivity / complications
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / immunology
  • Humans
  • Hypersensitivity, Immediate / complications
  • Hypersensitivity, Immediate / epidemiology
  • Hypersensitivity, Immediate / immunology*
  • Male
  • Middle Aged
  • Rhinitis, Allergic, Seasonal / complications
  • Rhinitis, Allergic, Seasonal / epidemiology
  • Rhinitis, Allergic, Seasonal / immunology
  • Skin Tests
  • Spain / epidemiology
  • Young Adult