Q:

3/22/2013
I have a patient with EoE and positive skin prick test for corn. Is it safe for them to drink Pediasure which contains corn maltodextrin?

A:

Thank you for your inquiry.

Unfortunately I cannot give you a definitive answer to your question, but I would say that it is very unlikely that maltodextrin would cause a problem in the patient you have described for the following reasons:

1.In most instances there is very little if any corn protein or glycoprotein contained in corn maltodextrin. However, this theoretically there could be an exception to this general rule. But I can use an analogy regarding wheat maltodextrin to give you some assurance that corn maltodextrin would probably be safe.

The European Food Safety Authority has looked at the issue of wheat allergen in wheat maltodextrin (wheat rather than corn is used most commonly in Europe to form maltodextrin). Although they could not give a definitive conclusion, they felt it was highly unlikely that patients allergic to wheat would have any difficulty with wheat maltodextrin because it is unlikely there would be sufficient wheat protein in this product to produce a reaction. They published a “white paper” on this issue, and copied below is the link to this should you wish to read it.

The EFSA (European Food Safety Authority) Journal (2007) 487, 1-7.

2.In addition, a positive skin test to any food does not necessarily mean that a patient will react to that food. The skin test is a measure of sensitivity and not necessarily allergy. Corn is not one of the common “Big 6” allergens that are felt to worsen eosinophilic esophagitis, and it is not included in the empiric diet that patients with eosinophilic esophagitis are oftentimes asked to follow (regardless of skin test reactivity). Thus, the fact that your patient has a positive skin test to corn or to any other food would not automatically suggest removal of that food from their diet.

Thus, I would think it very unlikely that your patient would have difficulty with corn maltodextrin mainly for reason Number 1 cited above.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology