Publications by authors named "Michele Shuker"
Clinical tolerance in eosinophilic esophagitis.
J Allergy Clin Immunol Pract
November 2019
Background: Evidence supports a possible link between eosinophilic esophagitis (EoE) and environmental aeroallergens, which can manifest as seasonal exacerbation of esophageal eosinophilia. Few studies have examined this link in pediatric patients with EoE.
Objective: To identify the proportion of patients with seasonal induced esophageal eosinophilia.
Article Synopsis
- Eosinophilic esophagitis (EoE) is a chronic inflammation of the esophagus often triggered by food, and this study examined how effective allergy testing-directed diets are for patients with EoE.
- Researchers analyzed data from 941 children with EoE, conducting skin prick tests (SPTs) and atopy patch tests (APTs) to identify problematic foods, revealing that milk, egg, wheat, and soy were the most common culprits.
- Both allergy testing-based diets and more generalized elimination diets showed similar success rates, with the allergy testing method usually requiring the removal of fewer foods to achieve resolution of esophageal eosinophilia.*
Alternatives to cow's milk and soy milk are often necessary for children with food allergies. Although hydrolyzed and elemental formulas are appropriate replacements, other milk products such as rice and almond milk are insufficient protein sources for children under 2 years of age. A chart review on three patients treated for protein malnutrition in association with multiple diagnosed food allergies that resulted in refractory eczema revealed adverse outcomes that resulted from elimination diets.
View Article and Find Full Text PDF14 years of eosinophilic esophagitis: clinical features and prognosis.
J Pediatr Gastroenterol Nutr
January 2009
Objective: To determine the natural history of treated and untreated eosinophilic esophagitis (EE) and examine the presenting symptoms of EE.
Patients And Methods: Retrospective and prospective chart review of all patients diagnosed with EE at The Children's Hospital of Philadelphia. EE was defined as greater than 20 eosinophils per high power field after treatment with reflux medications.
Eosinophilic esophagitis has been increasingly described in pediatric and adult literature. Several pediatric studies have indicated that food allergies are responsible for more than 90% of pediatric cases. There are three different dietary approaches to the management of eosinophilic esophagitis: (1) the elemental diet, (2) the removal of foods based on allergy testing, and (3) the removal of the foods that most commonly cause eosinophilic esophagitis.
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