Food allergies and eosinophilic esophagitis--two case studies

Area of Science:

• Gastroenterology
• Immunology
• Allergy

Background:

• Eosinophilic esophagitis (EE) is a growing clinical-pathological disorder.
• EE is linked to hypersensitivity to allergens and foods, but immediate food triggers are rarely confirmed.
• Existing food allergies and inhalant sensitivities often complicate diagnosis.

Observation:

• Two patients with allergic histories presented with acute dysphagia and vomiting after consuming specific foods (pulses, chicken).
• Diagnosis of EE was confirmed via endoscopy, histology, and esophageal manometry showing aperistalsis and simultaneous waves.
• Blood tests revealed hypereosinophilia.

Findings:

• Immediate hypersensitivity to specific foods was identified as the cause of EE in these patients.
• Topical fluticasone propionate and allergen avoidance led to remission of dysphagia and normalization of esophageal function.
• Symptom resolution persisted after steroid discontinuation, confirming food exposure as the trigger.

Implications:

• This study highlights immediate food hypersensitivity as a direct cause of EE.
• The findings suggest a pathophysiological mechanism involving IgE-mediated activation of eosinophils and mast cells.
• Understanding these mechanisms can improve EE diagnosis and management strategies.