1 - Allergy and Clinical Immunology Department, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, E.P.E, Lisbon, Portugal;
2 - Pediatric Department, Hospital Vila Franca de Xira, Lisbon, Portugal;
3 - CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisbon, Portugal; 4 Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital Dona Estefânia, CHLC, E.PE, Lisbon, Portugal
- Reunião Internacional, apresentação sob a forma de Poster, na European Academy of Allergy and Clinical Immunology Annual Congress
- Lisboa, 1-5 de Julho de 2019
Background: Eosinophilic esophagitis (EoE) is an immunemediated esophageal chronic disease, triggered by an abnormal allergic response to dietary antigens. The role of eviction diets in EoE management is still under debate and guided diet by skin prick tests (SPT) has been controversial in the pediatric population. The objective of our study is to compare the efficacy of two different diets: empiric cow 's milk eviction diet versus guided by SPT eviction diet in children.
Method: We developed a retrospective study that included demographical, clinical and endoscopic data of the children diagnosed with EoE referred to our Allergy and Clinical Immunology Department from the Pediatric Gastroenterology Unit, since January 2004 to June of 2018. We selected the patients under eviction diets based on SPT and empiric cow's milk diet and eliminated confusing factors like concomitant corticosteroids.
Results: We were able to identify 165 patients, 85% males, median age of 9 years old, and 40% of the patients had at least other atopic disease (eczema, asthma or rhinitis). The majority 58.18% (n = 96) of these patients performed elimination diets. In relation to the diets, from the 96 patients under diets, 30 (31.3%) were under guided by SPT elimination diet and 15 (15.6%) were under the empiric cow's milk eviction diet. Fifteen (50%) of the patients doing SPT guided diet presented symptoms and histological remission compared to 13 (87%) of the patients under cow's milk eviction diet (P = 0.03).
Conclusion: In our sample empiric cow 's milk eviction diet showed better results in inducing disease remission compared to SPTguided diet. These results support the already published papers that suggest empiric diet with only one food (milk) as an option diet.