EoE Module 13 References-Fogg et al J Allergy Clin Immunol 2003 Pollen and EoE

Fogg et al J Allergy Clin Immunol 2003 Pollen and EoE

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This letter to the editor discusses a potential link between pollen exposure and eosinophilic esophagitis (EE), a condition causing symptoms similar to gastroesophageal reflux. The letter details a case involving a 21-year-old female patient with EE, asthma, and allergic rhinoconjunctivitis, noting exacerbations of eosinophilic inflammation during pollen seasons with symptomatic improvements in winter. The patient's initial EE diagnosis was made due to persistent reflux symptoms, despite anti-reflux medication, with biopsies indicating eosinophilic inflammation. Subsequent winter biopsies showed significant symptom improvement and fewer eosinophils. However, during pollen seasons, biopsies repeatedly showed moderate to severe eosinophilic inflammation. The patient's diet and other indoor environmental exposures, such as dust or pet dander, were controlled without affecting her EE, further suggesting a relationship with pollen. A possible mechanism proposed is pollen deposition in the nasopharynx leading to swallowed secretions affecting the esophagus, akin to oral allergy syndrome. The case study aligns with animal models indicating an association between aeroallergens and EE, and highlights a potential role of inhalant allergens in the pathophysiology of EE beyond food allergies. It underscores the importance of exploring aeroallergens as potential contributors to EE, alongside existing findings that indicate a strong atopic tendency in patients with the condition. Further research is encouraged to better understand this connection and refine treatment strategies.

Keywords

eosinophilic esophagitis

pollen exposure

allergic rhinoconjunctivitis

gastroesophageal reflux

eosinophilic inflammation

aeroallergens

oral allergy syndrome

asthma

atopic tendency

treatment strategies