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Eosinophilic esophagitis, lack of benefit of skin testing and in-vitro testing

Question:

4/16/2018
In regards to eosinophilic esophagitis:
1) Is there an advantage to doing selected food skin testing versus in-vitro testing?
2) If food skin testing is negative, should in-vitro testing be done?

Answer:

We sought the expert opinion of Dr. Rothenberg. See his response below.

For Eosinophilic Esophagitis, there is no evidence that skin prick testing or serum food-specific IgE are valuable for guiding dietary therapy. This is likely related, at least in part, to the high level of IgG4, which counters IgE. If however, an EoE patient has co-existing food anaphylaxis, then there would be value of skin and serum testing, related to the anaphylaxis (not EoE).

Marc E. Rothenberg MD, PhD

Thank you for the question.
Patricia McNally, MD, FAAAAI