Recurrence of eosinophilic oesophagitis with subcutaneous grass pollen immunotherapy. 2018

Rosy Wells, and A T Fox, and Mark Furman
Paediatric Department, West Middlesex University Hospital, Isleworth, UK.

Case reports have described an association between oral food/aeroallergen immunotherapy with the development of eosinophilic oesophagitis (EoE). The underlying mechanism of this is poorly understood, as is the role that both food/aeroallergen sensitisation plays in the pathogenesis of EoE. Specific immunotherapy has a long-standing history of use in the management of moderate/severe seasonal allergic rhinitis (AR), caused by tree/grass pollens. Subcutaneous immunotherapy (SCIT) to grass pollen is less commonly used in children than sublingual immunotherapy (SLIT) or oral immunotherapy for practical reasons. We describe a case of a child with severe grass-pollen related AR and known, but quiescent, EoE, who developed recurrence of oesophageal symptoms on two separate occasions, coincident with the commencement of SLIT to grass pollen. He was subsequently started on SCIT to grass pollen and developed recurrence of symptoms of EoE-a phenomenon that has yet to be reported in the medical literature.

UI MeSH Term Description Entries
D007279 Injections, Subcutaneous Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin. Subcutaneous Injections,Injection, Subcutaneous,Subcutaneous Injection
D008297 Male Males
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003888 Desensitization, Immunologic Immunosuppression by the administration of increasing doses of antigen. Though the exact mechanism is not clear, the therapy results in an increase in serum levels of allergen-specific IMMUNOGLOBULIN G, suppression of specific IgE, and an increase in suppressor T-cell activity. Allergen Immunotherapy,Allergy Shots,Hyposensitization Therapy,Immunotherapy, Allergen,Venom Immunotherapy,Immunologic Desensitization,Therapy, Hyposensitization,Allergen Immunotherapies,Allergy Shot,Desensitizations, Immunologic,Hyposensitization Therapies,Immunologic Desensitizations,Immunotherapy, Venom,Shot, Allergy,Venom Immunotherapies
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006109 Poaceae A large family of narrow-leaved herbaceous grasses of the order Cyperales, subclass Commelinidae, class Liliopsida (monocotyledons). Food grains (EDIBLE GRAIN) come from members of this family. RHINITIS, ALLERGIC, SEASONAL can be induced by POLLEN of many of the grasses. Alopecurus,Arundo,Gramineae,Grasses,Imperata,Grass,Imperata cylindrica
D006255 Rhinitis, Allergic, Seasonal Allergic rhinitis that occurs at the same time every year. It is characterized by acute CONJUNCTIVITIS with lacrimation and ITCHING, and regarded as an allergic condition triggered by specific ALLERGENS. Hay Fever,Pollen Allergy,Pollinosis,Seasonal Allergic Rhinitis,Hayfever,Allergic Rhinitides, Seasonal,Allergic Rhinitis, Seasonal,Allergies, Pollen,Allergy, Pollen,Fever, Hay,Pollen Allergies,Pollinoses,Rhinitides, Seasonal Allergic,Rhinitis, Seasonal Allergic,Seasonal Allergic Rhinitides
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D057765 Eosinophilic Esophagitis Chronic ESOPHAGITIS characterized by esophageal mucosal EOSINOPHILIA. It is diagnosed when an increase in EOSINOPHILS are present over the entire esophagus. The reflux symptoms fail to respond to PROTON PUMP INHIBITORS treatment, unlike in GASTROESOPHAGEAL REFLUX DISEASE. The symptoms are associated with IgE-mediated hypersensitivity to food or inhalant allergens. Chronic Esophagitis, Eosinophilic,Esophagitis, Eosinophilic,Chronic Esophagitides, Eosinophilic,Eosinophilic Chronic Esophagitides,Eosinophilic Chronic Esophagitis,Eosinophilic Esophagitides,Esophagitides, Eosinophilic,Esophagitides, Eosinophilic Chronic,Esophagitis, Eosinophilic Chronic

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