PMID- 28981449
OWN - NLM
STAT- MEDLINE
DCOM- 20180503
LR  - 20200306
IS  - 1536-4801 (Electronic)
IS  - 0277-2116 (Print)
IS  - 0277-2116 (Linking)
VI  - 65
IP  - 5
DP  - 2017 Nov
TI  - Using Serum IgE Antibodies to Predict Esophageal Eosinophilia in Children.
PG  - 520-525
LID - 10.1097/MPG.0000000000001553 [doi]
AB  - OBJECTIVES: Symptoms of eosinophilic esophagitis are variable and can be 
      nonspecific. Food-specific serum immunoglobulin E (IgE) antibodies are frequently 
      found in patients with eosinophilic esophagitis and are obtained using a widely 
      available blood test. Our objective was to evaluate the ability of food-specific 
      IgE antibodies to predict the presence of esophageal eosinophilia. METHODS: We 
      reviewed 144 medical records for pediatric patients having esophageal biopsy and 
      serum analysis for IgE antibodies to food (exploratory group). We performed 
      logistic regression using sex and number of positive food-specific IgE tests to 
      develop a model that predicts >/=15 eosinophils/high-power field (hpf) in the 
      esophagus. We tested the model using 142 additional patients (validation group). 
      RESULTS: The probability of having >/=15 eosinophils/hpf in the esophagus was 
      higher in boys and increased with the number of positive food-specific IgE tests 
      from 12% (95% confidence interval 4.8-26) in girls with 0 foods positive to 86% 
      (95% confidence interval 71-94) for boys with 4 or 5 foods positive. The 
      statistical model using sex and number of positive IgE tests to predict patients 
      having >/=15 eosinophils/hpf showed acceptable discriminative ability (area under 
      the receiver operating characteristic curve 0.80). The performance metrics for 
      the model to predict >/=15 eosinophils/hpf in the validation group were similar 
      (area under the receiver operating characteristic curve 0.75). CONCLUSIONS: 
      Requiring only a blood test and a simple algorithm, analysis for IgE antibodies 
      to food may expedite an esophagogastroduodenoscopy and decrease delays in the 
      diagnosis and treatment of patients with nonspecific gastrointestinal symptoms 
      who have increased eosinophils in the esophagus.
FAU - Erwin, Elizabeth A
AU  - Erwin EA
AD  - *Center for Innovation in Pediatric Practice, Nationwide Children's Hospital 
      daggerDivision of Allergy and Immunology, Nationwide Children's Hospital and The Ohio 
      State University Wexner Medical Center, Columbus double daggerBiostat Global Consulting, 
      Worthington, OH  section signDivision of Allergy and Immunology, All Children's Hospital, 
      Sarasota, FL ||Division of Gastroenterology, Hepatology and Nutrition, Nationwide 
      Children's Hospital, Columbus, OH  paragraph signDivision of Allergy and Immunology, University 
      of Virginia, Charlottesville, VA.
FAU - Rhoda, Dale A
AU  - Rhoda DA
FAU - Redmond, Margaret
AU  - Redmond M
FAU - Ly, Jean B
AU  - Ly JB
FAU - Russo, John M
AU  - Russo JM
FAU - Hill, Ivor D
AU  - Hill ID
FAU - Platts-Mills, Thomas A E
AU  - Platts-Mills TAE
LA  - eng
GR  - K23 AI059317/AI/NIAID NIH HHS/United States
GR  - R01 AI020565/AI/NIAID NIH HHS/United States
GR  - R37 AI020565/AI/NIAID NIH HHS/United States
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - J Pediatr Gastroenterol Nutr
JT  - Journal of pediatric gastroenterology and nutrition
JID - 8211545
RN  - 0 (Biomarkers)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Biomarkers/blood
MH  - Child
MH  - Eosinophilic Esophagitis/*diagnosis/etiology/immunology
MH  - Feasibility Studies
MH  - Female
MH  - Food Hypersensitivity/complications/diagnosis/*immunology
MH  - Humans
MH  - Immunoglobulin E/*blood
MH  - Logistic Models
MH  - Male
MH  - ROC Curve
MH  - Sensitivity and Specificity
PMC - PMC5665571
MID - NIHMS853225
EDAT- 2017/10/06 06:00
MHDA- 2018/05/04 06:00
PMCR- 2018/11/01
CRDT- 2017/10/06 06:00
PHST- 2017/10/06 06:00 [pubmed]
PHST- 2018/05/04 06:00 [medline]
PHST- 2017/10/06 06:00 [entrez]
PHST- 2018/11/01 00:00 [pmc-release]
AID - 10.1097/MPG.0000000000001553 [doi]
PST - ppublish
SO  - J Pediatr Gastroenterol Nutr. 2017 Nov;65(5):520-525. doi: 
      10.1097/MPG.0000000000001553.