Esophageal hypereosinophilia induced by grass sublingual immunotherapy

Approximately 1 month later, the patient began to experience a mild sensation of retrosternal constriction, which worsened over the next few days with retrosternal pain and dysphagia related to tablet and food ingestion. Because of the suspicion of gastroesophageal reflux, a course of proton pump in...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2014-05, Vol.133 (5), p.1482-1484
Main Authors: Antico, Andrea, MD, Fante, Rossella, MD
Format: Article
Language:English
Subjects:
Adult
Allergens - administration & dosage
Allergens - adverse effects
Allergies
Allergy and Immunology
Biological and medical sciences
Biopsy
Dysphagia
Eosinophilia - chemically induced
Eosinophilia - immunology
Eosinophilia - pathology
Esophageal Diseases - chemically induced
Esophageal Diseases - immunology
Esophageal Diseases - pathology
Food
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Gastroesophageal reflux
Hematologic and hematopoietic diseases
Humans
Immunopathology
Immunotherapy
Male
Medical sciences
Other diseases. Hematologic involvement in other diseases
Pathogenesis
Pediatrics
Plant reproduction
Poaceae
Pollen
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Seasons
Sublingual Immunotherapy - adverse effects
Vaccines
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Description
Summary:Approximately 1 month later, the patient began to experience a mild sensation of retrosternal constriction, which worsened over the next few days with retrosternal pain and dysphagia related to tablet and food ingestion. Because of the suspicion of gastroesophageal reflux, a course of proton pump inhibitors (PPIs; 40 mg/d pantoprazole), prokinetic agents, antacids, and alginate was prescribed without any improvement. Long-term evolution of esophageal eosinophilia is not known. [...]we suggest considering the occurrence of esophagitis symptoms with esophageal eosinophilia as an absolute contraindication to continuing sublingual therapy with the culprit vaccine.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2014.01.030