Food-induced immediate response of the esophagus in pediatric eosinophilic esophagitis.
eosinophilic esophagitis (EoE)
food-induced immediate response of the esophagus (FIRE)
pediatrics
pollen-food allergy syndrome (PFAS)
Journal
Allergy
ISSN: 1398-9995
Titre abrégé: Allergy
Pays: Denmark
ID NLM: 7804028
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
revised:
21
07
2023
received:
07
06
2023
accepted:
10
08
2023
medline:
4
12
2023
pubmed:
13
9
2023
entrez:
13
9
2023
Statut:
ppublish
Résumé
Food-induced immediate response of the esophagus (FIRE) is a new phenomenon that has been described in eosinophilic esophagitis (EoE) patients. It is suspected when unpleasant symptoms occur suddenly on contact of the triggering food with the esophageal surface and recur with repeated exposures. It can often be mistaken for pollen-food allergy syndrome (PFAS) and solid food dysphagia. Data on FIRE is limited to one survey study and case reports, and there are no screening studies conducted on either adults or children with EoE. In this study, we aimed to screen children aged ≥7 years old with EoE for FIRE. Demographic data were collected from medical records. A questionnaire about FIRE was applied to all participants. Skin prick tests were done on suspected patients to identify the triggering foods. FIRE is defined as suitable clinical symptoms with suspected food allergen exposure. A total of 78 patients (74.4% male, median age: 13.5 years) were included. Unpleasant and recurrent symptoms distinct from dysphagia with specific foods were reported in 16.7% of the patients, all of whom had concomitant allergic rhinitis (AR). The symptoms described by almost all patients were oropharyngeal itching and tingling (PFAS: 15.3%) excluding only one patient reporting retrosternal narrowing and pressure after specific food consumption (FIRE: 1.2%). Although definitive conclusions regarding the true prevalence of FIRE cannot be made, it does not seem to be common as PFAS. However, it deserves questioning particularly in the presence of concurrent AR and/or PFAS in children with EoE.
Sections du résumé
BACKGROUND
Food-induced immediate response of the esophagus (FIRE) is a new phenomenon that has been described in eosinophilic esophagitis (EoE) patients. It is suspected when unpleasant symptoms occur suddenly on contact of the triggering food with the esophageal surface and recur with repeated exposures. It can often be mistaken for pollen-food allergy syndrome (PFAS) and solid food dysphagia. Data on FIRE is limited to one survey study and case reports, and there are no screening studies conducted on either adults or children with EoE. In this study, we aimed to screen children aged ≥7 years old with EoE for FIRE.
METHODS
Demographic data were collected from medical records. A questionnaire about FIRE was applied to all participants. Skin prick tests were done on suspected patients to identify the triggering foods. FIRE is defined as suitable clinical symptoms with suspected food allergen exposure.
RESULTS
A total of 78 patients (74.4% male, median age: 13.5 years) were included. Unpleasant and recurrent symptoms distinct from dysphagia with specific foods were reported in 16.7% of the patients, all of whom had concomitant allergic rhinitis (AR). The symptoms described by almost all patients were oropharyngeal itching and tingling (PFAS: 15.3%) excluding only one patient reporting retrosternal narrowing and pressure after specific food consumption (FIRE: 1.2%).
CONCLUSIONS
Although definitive conclusions regarding the true prevalence of FIRE cannot be made, it does not seem to be common as PFAS. However, it deserves questioning particularly in the presence of concurrent AR and/or PFAS in children with EoE.
Substances chimiques
Allergens
0
Fluorocarbons
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3235-3240Informations de copyright
© 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
Références
Steinbach EC, Hernandez M, Dellon ES. Eosinophilic esophagitis and the eosinophilic gastrointestinal diseases: approach to diagnosis and management. J Allergy Clin Immunol Pract. 2018;6:1483-1495.
Licari A, Votto M, D'Auria E, et al. Eosinophilic gastrointestinal diseases in children: a practical review. Curr Pediatr Rev. 2020;16:106-114.
Egritas Gurkan O, Ozturk H, Karagol HIE, et al. Primary eosinophilic gastrointestinal diseases beyond eosinophilic esophagitis in children. J Pediatr Gastroenterol Nutr. 2021;72:294-299.
Biedermann L, Holbreich M, Atkins D, et al. Food-induced immediate response of the esophagus-a newly identified syndrome in patients with eosinophilic esophagitis. Allergy. 2021;76:339-347.
Holbreich M, Straumann A. Features of food-induced immediate response in the esophagus (FIRE) in a series of adult patients with eosinophilic esophagitis. Allergy. 2021;76:2893-2895.
Carlson G, Coop C. Pollen food allergy syndrome (PFAS): a review of current available literature. Ann Allergy Asthma Immunol. 2019;123:359-365.
Votto M, Naso M, De Filippo M, et al. Food-induced immediate response of the esophagus: a first report in the pediatric age. Allergy. 2022;77:711-712.
Poncet P, Sénéchal H, Charpin D. Update on pollen-food allergy syndrome. Expert Rev Clin Immunol. 2020;16:561-578.
Warners MJ, Terreehorst I, van den Wijngaard RM, et al. Abnormal responses to local esophageal food allergen injections in adult patients with eosinophilic esophagitis. Gastroenterology. 2018;154:57-60.e2.
Shim J, Patil S. Cross-reactive food and pollen allergens most commonly involved in oral allergy syndrome in adults with eosinophilic esophagitis. J Allergy Clin Immunol. 2023;151(2):AB90.
Letner D, Farris A, Khalili H, Garber J. Pollen-food allergy syndrome is a common allergic comorbidity in adults with eosinophilic esophagitis. Dis Esophagus. 2018;31(2):1-8.
Mahdavinia M, Bishehsari F, Hayat W, Elhassan A, Tobin MC, Ditto AM. Association of eosinophilic esophagitis and food pollen allergy syndrome. Ann Allergy Asthma Immunol. 2017;118:116-117.
Sessions J, Purington N, Wang Y, et al. Pediatric eosinophilic esophagitis outcomes vary with co-morbid eczema and pollen food syndrome. Front Allergy. 2022;3:981961.
Ertoy Karagöl Hİ, Yapar D, Eğritaş Gürkan Ö, et al. Reliability and validity study of Turkish version of pediatric eosinophilic esophagitis symptom scores® (tr-PEESS v2.0) led to development of a new pediatric eosinophilic esophagitis scale: GaziESAS. Turk J Gastroenterol. 2021;32:365-373.
Yapar D, Karagol HIE, Terece SP, et al. A novel pediatric eosinophilic esophagitis symptoms and adaptive behavior scale for different ages: GaziESAS v2.0. Pediatr Allergy Immunol. 2023;34(6):e13974.