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Vol. 34. Issue 2.
Pages 79-81 (March 2006)
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Vol. 34. Issue 2.
Pages 79-81 (March 2006)
DOI: 10.1157/13086753
Eosinophilic esophagitis
Esofagitis eosinofílica
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Judith Antón Remíreza, Rosario Escuderoa, Óscar Cáceresa, Margarita Fernández-Beníteza
a Department of Allergology and Clinical Immunology. Clínica Universitaria. Facultad de Medicina. Universidad de Navarra. Pamplona. Spain.
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Figure 3. --Evolution of our patient's peripheral eosinophilia since 1998 to 2005.
Background: Esophagitis is an increasingly diagnosed disease. Patients with gastroesophagic reflux, dysphagia, vomiting or abdominal pain, with a torpid response to the treatment, could be suffering from it. Material and methods: A 37 year-old male patient with background of gastroesophagic reflux and dysphagia for solids since 2002, self-limited diarrhea episodes and intolerance to alcoholic drinks due to epigastric pain. Skin prick tests, specific IgE, histamine release test and basophil activation test were carried out. Results: Skin prick test to the usual allergens with negative result; prick-prick tests to egg white and yolk, milk and apple with positive result to egg white; total serum IgE within normal levels, specific IgE to egg white with positive result; histamine release test (HRT) and basophil activation test (BAT) with positive result to egg white and yolk. Conclusion: The patient was diagnosed eosinophilic esophagitis. The commercial food extracts have a great variability in their allergenic composition, which could result in false negative results in the prick test. Prick-prick with the natural food is a more sensitive technique than prick in the diagnosis of food allergy. There are other useful in vitro techniques, apart from specific IgE, in the diagnosis of food allergy. In our case, an exclusion diet of the involved food was more effective than other treatments for remission of the symptoms.
Keywords:
Eosonophilic esophagitis
Food allergy
Egg
Dysphagia
Prick-prick test
Basophil activation test
Histamine release test
Montelukast
Introducción: La esofagitis eosinofílica es una entidad cada vez más diagnosticada. Pacientes que presentan síntomas de reflujo gastroesofágico, disfagia, vómitos o dolor abdominal con mala respuesta al tratamiento, pueden tener esta enfermedad. Presentamos el caso de un paciente varón de 37 años con antecedente de reflujo gastroesofágico y disfagia para sólidos desde 2002, episodios diarreicos autolimitados e intolerancia al alcohol por dolor epigástrico, que fue diagnosticado de esofagitis eosinofílica. Material y métodos: En el estudio alergológico realizado se efectuaron pruebas cutáneas (Prick) a los alergenos habituales con resultado negativo; pruebas cutáneas (Prick-Prick) frente a clara y yema de huevo, leche y manzana con resultado positivo frente a clara; IgE sérica total que resultó dentro de la normalidad, IgE específica frente a clara de huevo con resultado positivo; Test de Liberación de Histamina (TLH) y Test de Activación de Basófilos (TAB) con resultado positivo frente a clara y yema. Conclusion: Los extractos comerciales a alimentos presentan gran variabilidad en su composición alergénica, lo que puede dar resultados falsamente negativos en el prick. El prick-prick con el alimento en estado natural es una técnica más sensible y que ha demostrado una rentabilidad diagnóstica mayor que el prick en el diagnóstico de alergia a alimentos. Existen otras técnicas in vitro además de la IgE específica que sirven para el diagnóstico de la alergia alimentaria. En nuestro caso, una dieta de exclusión del alimento implicado resultó ser más determinante que otros tratamientos para la resolución de los síntomas.
Palabras clave:
Eosonophilic esophagitis
Food allergy
Egg
Dysphagia
Prick-prick test
Basophil activation test
Histamine release test
Montelukast

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