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FOOD-INDUCED IMMEDIATE RESPONSE OF THE ESOPHAGUS (FIRE) IN PEDIATRIC EOSINOPHILIC ESOPHAGITIS
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  • Gizem Koken,
  • Hacer Ertoy Karagol,
  • Sinem Polat Terece,
  • Zeynep Cavdar,
  • Kenan Cetin,
  • Odul Gurkan,
  • Sinan Sari,
  • Buket Dalgic,
  • Arzu Bakirtas
Gizem Koken
Gazi University Faculty of Medicine
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Hacer Ertoy Karagol
Gazi University Faculty of Medicine
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Sinem Polat Terece
Gazi University Faculty of Medicine
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Zeynep Cavdar
Gazi University Faculty of Medicine
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Kenan Cetin
Gazi University Faculty of Medicine
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Odul Gurkan
Gazi University Pediatric Eosinophilic Gastrointestinal Diseases Working Group
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Sinan Sari
Gazi University Pediatric Eosinophilic Gastrointestinal Diseases Working Group
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Buket Dalgic
Gazi University Pediatric Eosinophilic Gastrointestinal Diseases Working Group
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Arzu Bakirtas
Gazi University Faculty of Medicine

Corresponding Author:[email protected]

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Abstract

Background: Food-induced immediate response of the esophagus (FIRE) is a new phenomenon that has been described in eosinophilic esophagitis (EoE) patients. It is suspected when unpleasant symptoms occur suddenly on contact of the triggering food with the esophageal surface and recur with repeated exposures. It can often be mistaken for pollen-food allergy syndrome (PFAS) and solid food dysphagia. Data on FIRE is limited to one survey study and case reports, and there are no screening studies conducted on either adults or children with EoE. In this study, we aimed to screen children aged ≥7 years old with EoE for FIRE. Methods: Demographic data were collected from medical records. A questionnaire about FIRE was applied to all participants. Skin prick tests (SPTs) were done on suspected patients to identify the triggering foods. FIRE is defined as suitable clinical symptoms with suspected food allergen exposure. Results: Seventy-eight patients (74.4% male, median age: 13.5 years) were included. Unpleasant and recurrent symptoms distinct from dysphagia with specific foods were reported in %16.7 of the patients, all of whom had concomitant allergic rhinitis (AR). The symptoms described by almost all patients were oropharyngeal itching and tingling (PFAS: 15.3%) excluding only one patient reporting retrosternal narrowing and pressure after specific food consumption (FIRE: 1.2%). Conclusions: Although definitive conclusions regarding the true prevalence of FIRE cannot be made, it does not seem to be common as PFAS. However, it deserves questioning particularly in the presence of concurrent AR and/or PFAS in children with EoE.
08 Jun 2023Submitted to Allergy
08 Jun 2023Submission Checks Completed
08 Jun 2023Assigned to Editor
08 Jun 2023Review(s) Completed, Editorial Evaluation Pending
10 Jun 2023Reviewer(s) Assigned
23 Jun 2023Editorial Decision: Revise Minor
22 Jul 20231st Revision Received
22 Jul 2023Submission Checks Completed
22 Jul 2023Assigned to Editor
22 Jul 2023Review(s) Completed, Editorial Evaluation Pending
25 Jul 2023Reviewer(s) Assigned
14 Aug 2023Editorial Decision: Accept
13 Sep 2023Published in Allergy. 10.1111/all.15881