1. Useful Biomarkers in Pediatric Eosinophilic Duodenitis and Their Existence: A Case-control, Single-blind, Observational Pilot Study
- Author
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Craig A. Friesen, Nancy A Neilan, Debra L Taylor, Pam Ryan, Jennifer Verrill Schurman, and Paul J Dowling
- Subjects
Male ,medicine.medical_specialty ,Allergy ,Adolescent ,Pilot Projects ,Atopy ,Duodenitis ,Internal medicine ,Eosinophilia ,Odds Ratio ,medicine ,Humans ,Single-Blind Method ,Dyspepsia ,Child ,Somatoform Disorders ,business.industry ,Incidence (epidemiology) ,Gastroenterology ,Case-control study ,Patch test ,Odds ratio ,Immunoglobulin E ,Patch Tests ,medicine.disease ,Confidence interval ,Surgery ,Eosinophils ,ROC Curve ,Case-Control Studies ,Immunoglobulin G ,Pediatrics, Perinatology and Child Health ,Female ,business ,Biomarkers ,Food Hypersensitivity - Abstract
Objectives: The aim of this study was to determine whether screening for food hypersensitivity could be a clinically useful biomarker for eosinophilic duodenitis in the pediatric population. Patients and Methods: Twenty-two patients with functional dyspepsia and 19 controls with no significant history of gastrointestinal or allergic disorders were enrolled. Participants underwent skin prick, atopy patch, and serum-specific (S)-IgE, -IgG, and -IgG 4 testing to corn, wheat, soy, peanut, milk, and egg. Participants in the patient group also underwent endoscopy with biopsies as part of standard care. Results: Three participants in the patient group did not exhibit duodenal eosinophilia on biopsy and were excluded from data analyses. The patient group consisted of 13 females and 6 males, 8 to 17 years of age. The control group consisted of 10 females and 9 males, 8 to 17 years of age. Seven patients had at least 1 positive reaction to food by skin prick, atopy patch, or SIgE testing compared with 7 controls; odds ratio 1; 95% confidence interval 0.3 to 3.7. Receiver operating characteristics curves showed SIgG and SIgG 4 performed poorly or no better than chance for predicting group assignment. Conclusions: Allergy screening for the foods tested was not useful as a biomarker for eosinophilic duodenitis in this small study. A higher rate of positive reactions to patch testing was observed in the control group than previous studies have reported. The incidence of a positive food patch test in nonselected subjects needs further investigation. Method standardization and establishment of reference intervals are needed for atopy patch tests, SIgG, and SIgG 4 to better evaluate the clinical value of these measures.
- Published
- 2010