Document Detail

Food allergies and eosinophilic esophagitis--two case studies.
MedLine Citation:
PMID:  17068399     Owner:  NLM     Status:  MEDLINE    
Eosinophilic esophagitis (EE) is a clinical-pathological disorder which is being increasingly diagnosed. It is etiologically associated with hypersensitivity to airborne allergens and/or dietary components. However, immediate hypersensitivity to foods has rarely been proven as the etiologic cause of the disorder. Two patients are presented with a history of rhinoconjunctivitis, allergic asthma, atopic dermatitis and food allergies which are currently under control and who show specific IgE to pulses and chicken respectively. These patients developed acute dysphagia and vomiting immediately after ingesting these foods and following appropriate examination were diagnosed as suffering from EE. The study also showed signs of blood hypereosinophilia while the esophageal manometry revealed a motor disorder characterized by aperistalsis and non-propulsive simultaneous waves affecting the lower two-thirds of the organ composed of smooth muscle. Topical treatment with fluticasone propionate was administered over a period of 3 months, in addition to a diet abstaining from the aforementioned foods and this led to remission of dysphagia and normalization of the endoscopic, histological and manometric studies of the esophagus. This situation remained stable for a considerable length of time after steroid treatment was discontinued, which showed that exposure to foods seemed to be the cause of the esophageal disorder. Similarly, allergies to inhalants and other digestive symptoms which appear upon immediate ingestion of the foods involved would not justify the sudden onset of dysphagia. We offer a pathophysiological explanation for the mechanisms of the disease based on the activation of eosinophils and mast cells by IgE and their ability to disturb the dynamic behavior of the neural and muscle components of the esophageal wall.
María F Martín-Muñoz; Alfredo J Lucendo; Marta Navarro; Antonio Letrán; Sonia Martín-Chávarri; Emilio Burgos; M Martín-Esteban
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-10-26
Journal Detail:
Title:  Digestion     Volume:  74     ISSN:  0012-2823     ISO Abbreviation:  Digestion     Publication Date:  2006  
Date Detail:
Created Date:  2006-11-30     Completed Date:  2007-02-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150472     Medline TA:  Digestion     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  49-54     Citation Subset:  IM    
Allergy Service, Pediatric Hospital, Madrid, Spain.
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MeSH Terms
Androstadienes / therapeutic use
Anti-Allergic Agents / therapeutic use
Chickens / immunology
Deglutition Disorders / immunology
Eosinophilia / immunology*
Esophagitis / immunology*
Fabaceae / immunology
Food Hypersensitivity / complications*,  diagnosis,  drug therapy
Immunoglobulin E
Reg. No./Substance:
0/Androstadienes; 0/Anti-Allergic Agents; 37341-29-0/Immunoglobulin E; 90566-53-3/fluticasone

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