The coexistence of eosinophilic esophagitis with allergic rhinitis

A. Soylu, A. Altintas, S. Cakmak, S. Poturoglu, H. Kaya, I. Sevindir, Y. Okuturlar, N. Sever

Department of Gastroenterology, Department of Otolaryngology, Department of Internal Medicine, Department of Pathology; Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey. asoylu2@hotmail.com

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• Gastroenterology

OBJECTIVE: Eosinophilic esophagitis (EoE) is diagnosed with the presence of characteristic esophageal symptoms and eosinophilic infiltration of the esophageal mucosa after other causes of eosinophilia are excluded. EoE has been reported to co-occur with some allergic diseases. In this study, we evaluated the co-existence of EoE in Ear-Nose-Throat (ENT) outpatient clinic patients with allergic rhinitis (AR).

PATIENTS AND METHODS: The study group consists of 67 AR patients (AR group) and the control group (CG) was formed with 53 cases with dyspepsia symptoms. Symptoms of AR and CG groups were compared in terms of endoscopic and histological findings. Moreover, in AR group, accompanying symptoms, immunoglobulin E (IgE), skin prick test (SPT) positivity, Helicobacter pylori (H. pylori) presence, endoscopic findings and biopsy results were compared between patients with EoE and those without.

RESULTS: Seven of the cases with AR were diagnosed with EoE. Reflux symptoms were more common in patients with EoE (71.4%). The presence of H. pylori was similar between groups. Blood IgE levels were significantly higher among EoE patients compared to those without EoE (p = 0.003). SPT positivity was present in the 85.7% of patients with EoE and 50% of the patients without EoE (p = 0.113). Allergens were more likely to be mites Dermatophagoides farinae and Dermatophagoides pteronyssinus in patients with EoE (p = 0.042 and p = 0.034 respectively).

CONCLUSIONS: The most common symptom among patients with EoE is reflux. In AR patients with EoE, serum IgE levels were higher compared to those without EoE. In AR patients with reflux symptoms, high serum IgE levels, and especially in patients whose tests are positive for allergy to mites, referral to a gastroenterologist for EoE evaluation may be recommended.

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