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In reply: Eosinophilic esophagitis

In Reply: I am most grateful to Drs. Theodoropoulos and Morris for their letter. I fully agree that we are getting smarter with diet elimination therapies by introducing more than one food at a time in the hope that we can lessen the number of endoscopies needed to isolate specific antigenic causes of eosinophilic esophagitis. This is not always successful, but in some of the more fortunate patients, we can get by with one or two endoscopies. It is my hope that with less-invasive tools such as the Cytosponge, the esophageal string test, and perhaps even serum evaluations, we can further embrace diet therapy as a standard treatment in more patients with eosinophilic esophagitis.

I think it is also important to note that although traditional radioallergosorbent and skin testing was only 45% accurate for eosinophilic esophagitis in the meta-analysis cited, this testing is still important, given the number of IgE-related allergies additionally uncovered in patients with eosinophilic esophagitis.

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David A. Katzka, MD
Mayo Clinic, Rochester, MN

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In Reply: I am most grateful to Drs. Theodoropoulos and Morris for their letter. I fully agree that we are getting smarter with diet elimination therapies by introducing more than one food at a time in the hope that we can lessen the number of endoscopies needed to isolate specific antigenic causes of eosinophilic esophagitis. This is not always successful, but in some of the more fortunate patients, we can get by with one or two endoscopies. It is my hope that with less-invasive tools such as the Cytosponge, the esophageal string test, and perhaps even serum evaluations, we can further embrace diet therapy as a standard treatment in more patients with eosinophilic esophagitis.

I think it is also important to note that although traditional radioallergosorbent and skin testing was only 45% accurate for eosinophilic esophagitis in the meta-analysis cited, this testing is still important, given the number of IgE-related allergies additionally uncovered in patients with eosinophilic esophagitis.

In Reply: I am most grateful to Drs. Theodoropoulos and Morris for their letter. I fully agree that we are getting smarter with diet elimination therapies by introducing more than one food at a time in the hope that we can lessen the number of endoscopies needed to isolate specific antigenic causes of eosinophilic esophagitis. This is not always successful, but in some of the more fortunate patients, we can get by with one or two endoscopies. It is my hope that with less-invasive tools such as the Cytosponge, the esophageal string test, and perhaps even serum evaluations, we can further embrace diet therapy as a standard treatment in more patients with eosinophilic esophagitis.

I think it is also important to note that although traditional radioallergosorbent and skin testing was only 45% accurate for eosinophilic esophagitis in the meta-analysis cited, this testing is still important, given the number of IgE-related allergies additionally uncovered in patients with eosinophilic esophagitis.

Issue
Cleveland Clinic Journal of Medicine - 82(6)
Issue
Cleveland Clinic Journal of Medicine - 82(6)
Page Number
332-333
Page Number
332-333
Publications
Publications
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In reply: Eosinophilic esophagitis
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In reply: Eosinophilic esophagitis
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eosinophilic esophagitis, allergy, David Katzka
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eosinophilic esophagitis, allergy, David Katzka
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