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Related Concept Videos

Other Disorders of Digestive System01:30

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The gastrointestinal tract is susceptible to various disorders. If the lower esophageal sphincter is damaged, stomach acid can flow back into the esophagus, causing irritation and inflammation of the lining. This condition is called gastroesophageal reflux disease (known as heartburn) and may cause chest pain and difficulty swallowing. In the stomach, prolonged use of nonsteroidal anti-inflammatory drugs like aspirin, chronic alcohol consumption, bacterial infections such as Helicobacter...
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Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
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Esophageal dysfunction and immunological changes induced by grass sublingual immunotherapy.

C Perales Chordá1, E Sáez González2, J Martí Garrido3

  • 1Department of Allergy, Hospital La Fe, Valencia, Spain. Phone: +34 679 633 188

European Annals of Allergy and Clinical Immunology
|January 26, 2017
PubMed
Summary

Sublingual immunotherapy for grass pollen allergy can cause esophageal issues. This case highlights the need to investigate immunological changes linked to these adverse events during treatment.

Keywords:
Immunoglobulin IgEPhleumesophageal diseasessublingual immunotherapy

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Area of Science:

  • Immunology
  • Allergology
  • Gastroenterology

Background:

  • Sublingual immunotherapy (SLIT) is a common treatment for allergic rhinoconjunctivitis.
  • Oropharyngeal adverse events are typical but usually mild and self-limiting.
  • Immunological mechanisms involve shifts in immunoglobulin G4 (IgG4) and immunoglobulin E (IgE) responses.

Observation:

  • A 25-year-old male with grass pollen allergy experienced severe esophageal dysfunction after initiating Phleum pratense SLIT.
  • Symptoms occurred immediately post-administration, resolved spontaneously, and ceased upon treatment discontinuation.
  • This coincided with a significant elevation in total and specific IgE levels.

Findings:

  • The patient's esophageal symptoms were temporally associated with SLIT initiation.
  • Elevated IgE levels suggest a potential role in the observed adverse event.
  • Immunological changes, including IgE fluctuations, gradually normalized over three years post-therapy.

Implications:

  • This case suggests a potential link between SLIT-induced immunological changes and esophageal dysfunction.
  • Further research is needed to understand the role of specific immunological shifts in SLIT-related esophageal disorders.
  • Clinicians should consider esophageal symptoms as a potential adverse event in patients undergoing SLIT, particularly with Phleum pratense.