Eosinophilic esophagitis: a matter of flavoring
© Gomes et al; licensee BioMed Central Ltd. 2015
Published: 30 March 2015
Eosinophilic esophagitis (EoE) is an inflammatory disease characterized by eosinophilic infiltration of the esophageal wall. It is an increasingly recognized disease that affects mostly caucasian males in two peaks of incidence: 5-10/20-40 years. Studies show that more than 90% of this patients are sensitized to mite or polens, 50% to food, and that the contact with them exacerbates the disease.
- (1)Skin prick tests (mm):
Food and spices: curry 10; mustard 10; paprika 6; cumin 3
Aeroallergens: Histamine 4; birch 3; grass polen 6; Dermatophagoides pteronyssinus (Dp) 8; Lepidoglyphus destructor (Ld) 15.
Prick-to-prick tests (mm): paprika 16; curry 15; cinnamon 15; mustard 14; saffron 7
- (2)Laboratory tests:
Normal blood count, protein concentrations, renal and liver function
IgG 15.3g/dL, IgA 3.1g/dL, IgM 0.47g/dL, IgE 1440Ul/ml
Specific IgE (kU/L): Dactylis glomerata 47,1; Phleum pratense 19,2; Betula verrucosa 2,52; Dp 53,4 e Ld 8,7
(3) UGIE (2012): Shatski ring and ulceration downstream. Biopsies: eosinophilic infiltrate (40cel/high-powered field), microabscesses of the wall
He began avoid those condiments/spices and use topical corticosteroids (TC) for esophageal mucosa, basic mite eviction and hygiene measures. He remained asymptomatic and 3 months after stopping the TC, a control UGIE was performed. It showed no macroscopical changes and biopsy revealed a reduction of eosinophilic infiltration (15cel/HPF). With this case report we intend to highlight the importance of recognizing EoE and identify exacerbating factors considering the importance of the avoiding measures in the disease control.
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