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Updated: Oct 19, 2025

Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
A case series of sublingual immunotherapy-induced eosinophilic esophagitis: stop or spit
Yasuhiro Fujiwara1, Fumio Tanaka2, Akinari Sawada2
1Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan. yasu@med.osaka-cu.ac.jp.
Abstract:
We experienced six cases with eosinophilic esophagitis (EoE). They complained of dysphagia, heartburn, or retrosternal discomfort. Endoscopy revealed typical findings of EoE and biopsy examination showed significant eosinophil infiltration in the esophageal epithelium. They received sublingual immunotherapy (SLIT) for allergic rhinitis. Discontinuation or spit method during SLIT resulted in improvement of symptoms, and endoscopic and histological remission. Previously six cases with SLIT-induced EoE has been reported. Our case series suggest that SLIT is clearly associated with the development of EoE by entering of aeroallergens from the luminal side of the esophagus and spit method during SLIT might be one of the therapeutic options for SLIT-induced EoE.
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