Dr Brian T. Kelly on the recognition of EoE, non-IgE-mediated food allergies


Brian T. Kelly, MD, MA, FACAAI, Midwest Allergy and Asthma Clinic and Program Chair of the American College of Allergy, Asthma & Immunology Annual Meeting, discusses the importance of distinguishing between non-immunoglobulins E (IgE) and IgE mediated food allergies, as well as stay up to date on advice for eosinophilic esophagitis (EoE).

It’s important to promote awareness of those things we don’t necessarily receive formal training on, as well as helping guide our patients who sometimes have difficulty navigating this world of food allergies, stressed Brian T. Kelly, MD, MA, FACAAI, Midwest. Allergy and Asthma Clinic and program chair for the American College of Allergy, Asthma & Immunology 2021 Annual Scientific Meeting, which hosts and presents this year’s conference sessions.


Is it difficult to refer infants and children with suspected EoE and FPIES to a specialist for evaluation? If so, what can be done?

I think non-IgE [immunoglobulin E]–Medicated food allergies are not necessarily always at the forefront of some of our referral sources. Some of these things, like the FPIES [food protein–induced enterocolitis syndrome], are rare and not necessarily something that comes up over and over again in pediatric education. Often times, we see these patients out of the emergency room or when they come to the pediatrician for some other problem, such as an IgE-mediated food allergy. I think it’s somewhat difficult for patients to navigate this world. One thing I think the ACAAI and others have done a great job of is promoting some of the awareness of these non-IgE-mediated food allergies, as they are somewhat overlooked in terms of true IgE-mediated food allergy. – and they ‘are quite different, so we really wanted to highlight this by hosting a session [“Addressing Non-IgE Mediated Food Allergy”] who addresses this specifically with some of the most prominent experts in non-IgE-mediated food allergy.

EoE [eosinophilic esophagitis], in and of itself, is really an area where things have changed over the years. Even some of the guidelines have changed and been updated recently. In fact, we talked about the most recent updated guidelines at the 2020 meeting. It’s really important for allergists and immunologists to stay on top of these. We’re going to keep pushing for that, because we see a lot of these patients in the clinic and the recommendations on what to test and how to test, and all of that stuff, has changed. It will therefore be important to keep our members at the forefront.

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