Induction of Eosinophilic Esophagitis by Sublingual Pollen Immunotherapy

• Main Authors: Stephan Miehlke, Oral Alpan, Sören Schröder, Alex Straumann
• Format: Article
• Language: English
• Published: Karger Publishers 2013-09-01
• Series: Case Reports in Gastroenterology
• Subjects: Pollen allergy; Sublingual immunotherapy; Eosinophilic esophagitis; Food allergy; Dysphagia
• Online Access: http://www.karger.com/Article/FullText/355161

Sublingual immunotherapy (SLIT) is increasingly investigated and utilized for the treatment of food and pollen allergies. Previous case reports suggested that eosinophilic esophagitis (EoE) might develop as a long-term complication in children after completion of oral immunotherapy. Here, we describe a 44-year-old female with a medical history of pollinosis who for the first time in her life developed complete manifestation of EoE (peak eosinophils 164/high power field) 4 weeks after initiation of SLIT using specific soluble allergens (hazelnut, birch, alder) according to previous specific serum IgE testing. After discontinuation of SLIT, EoE resolved completely within 4 weeks without any other medical intervention. During a follow-up of 12 months the patient remained free of any esophageal symptoms. This is the first case report demonstrating a close and therefore likely causative association between pollen SLIT and EoE in an adult patient.