Eosinophilic esophagitis and colonic mucosal eosinophilia in Netherton syndrome

Food allergies rapidly become a dominant trait, persist throughout life, and are related to a high level of total and specific IgE (sIgE) to foods.2 Clinical manifestations may involve digestive symptoms, and recently eosinophilic esophagitis (EoE) in 1 child with NS has been reported.2 We shared this experience of EoE in 1 child with NS in our French reference center (MAGEC Center, Necker-Enfants-Malades Hospital, Paris, France) and thus included digestive endoscopy in the routine workup of patients with NS when presenting with digestive symptoms. Diet was normal in only 1 patient, whereas 11 patients were carrying out an elimination diet of staple foods (milk and dairy products, egg, and/or wheat), in association with more specific eliminations in 9 patients (eg, peanuts, fish, and soy), based on parents' observation. The expression of LEKTI was tested in the esophageal mucosa of all patients with NS, and compared with 15 routine esophageal samples (without EoE), and with 10 esophageal samples of patients with EoE without NS (with comparative analysis of a positive normal skin control and the demonstration of internal negative control areas for every sample). NAFish: NATree nuts: 12.5 Egg white: