Dr Brian T. Kelly on Recognizing EoE, Non-IgE–Mediated Food Allergies

Brian T. Kelly, MD, MA, FACAAI, Midwest Allergy and Asthma Clinic, and the American College of Allergy, Asthma & Immunology annual meeting program chair, discusses the importance of distinguishing between non–immunoglobulin E (IgE)– and IgE-mediated food allergies, as well as remaining up to date on guidance for eosinophilic esophagitis (EoE).

It’s important to promote awareness around these things we don’t necessarily receive formal training on, as well as to help 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 the American College of Allergy, Asthma & Immunology 2021 Annual Scientific Meeting program chair, who is both moderating and presenting sessions at this year's conference.


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

I think non-IgE [immunoglobulin E]–mediated food allergies is something that’s not necessarily always at the forefront of some of our referral sources. Some of these things, such as FPIES [food protein–induced enterocolitis syndrome], are rare and not necessarily something that always comes up in pediatric training. Oftentimes, we see these patients out of the emergency room or when they've come from the pediatrician for another concern, such as an IgE-mediated food allergy. I think it is somewhat difficult for patients to navigate that world. One thing that I think the ACAAI and others have done a great job of doing is promoting some of the awareness of these non-IgE–mediated food allergies, because they get somewhat neglected in terms of true IgE-mediated food allergy—and they're quite different—and so we really wanted to highlight that by putting together a session [“Addressing Non-IgE Mediated Food Allergy”] that addresses that 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 throughout 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 up to date on those. We're going to continue to push for that, because we do see those patients a lot in clinic and the recommendations on testing and how to test, and all of those things, have changed. So keeping our members at the forefront of that is going to be important.