Eosinophilic Esophagitis And Food Allergy In Celiac Disease

Background: Celiac disease, eosinophilic esophagitis, and food allergy are chronic immune-mediated gastrointestinal disorders with increasing incidences. Aims: Considering the notable shared etiological characteristics among these conditions, this study aimed to investigate the relationship between celiac disease, eosinophilic esophagitis, and food allergy. Methods: Medical records of pediatric patients diagnosed with celiac disease who underwent esophageal biopsy were reviewed for eosinophilic esophagitis. Additionally, histopathology reports of pediatric patients diagnosed with eosinophilic esophagitis were assessed for celiac disease. Patients were evaluated on the basis of clinical symptoms of food allergy, food-specific skin prick tests, serum-specific IgE tests, and improvement of symptoms with dietary interventions. Results: Eosinophilic esophagitis was identified in 6% (n = 7/114) of the patients with celiac disease who underwent esophageal biopsy. Celiac disease was observed in 19% (n = 7/36) of the patients diagnosed with eosinophilic esophagitis. Among 44 patients with a history of food allergy, 52% (n = 23/44) were found to have IgE-mediated food allergy, and 14% (n = 6/44) were diagnosed with non-IgE-mediated food allergy. Additionally, 34% (n = 15/44) of the patients with a history of food allergy were found not to have food allergy. Conclusion: Celiac disease, food allergy, and eosinophilic esophagitis may present with similar clinical symptoms. Therefore, in cases where celiac disease does not respond to a gluten-free diet, the potential coexistence of food allergy and eosinophilic esophagitis should be considered. Further studies are warranted to establish whether the prevalence of food allergy and eosinophilic esophagitis is increased in celiac disease and to determine if routine screening for these conditions should be recommended in celiac patients.