Recurrence of Eosinophilic Oesophagitis with Subcutaneous Grass Pollen Immunotherapy

R Wells, M Furman and A Fox

Department of Allergy, St Thomas’s Hospital, London
Department of Allergy, Royal Free Hospital, London

^*Correspondance to: R Wells 

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Abstract:

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

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Cite the Article:

Wells R, Furman M, Fox A. Recurrence of Eosinophilic Oesophagitis with Subcutaneous Grass Pollen Immunotherapy. Ann Clin Case Rep. 2017; 2: 1227.