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Recurrence of eosinophilic oesophagitis with subcutaneous grass pollen immunotherapy
  1. Rosy Wells1,
  2. A T Fox2,
  3. Mark Furman3
  1. 1Paediatric Department, West Middlesex University Hospital, Isleworth, UK
  2. 2Children’s Allergy Service, Guys and St Thomas’ NHS Trust, London, UK
  3. 3Paediatric Gastroenterology, Royal Free London NHS Foundation Trust, London, UK
  1. Correspondence to Dr Rosy Wells, rosywells{at}


Case reports have described an association between oral food/aeroallergen immunotherapy with the development of eosinophilic oesophagitis (EoE). The underlying mechanism of this is poorly understood, as is the role that both food/aeroallergen sensitisation plays in the pathogenesis of EoE. Specific immunotherapy has a long-standing history of use in the management of moderate/severe seasonal allergic rhinitis (AR), caused by tree/grass pollens. Subcutaneous immunotherapy (SCIT) to grass pollen is less commonly used in children than sublingual immunotherapy (SLIT) or oral immunotherapy for practical reasons. We describe a case of a child with severe grass-pollen related AR and known, but quiescent, EoE, who developed recurrence of oesophageal symptoms on two separate occasions, coincident with the commencement of SLIT to grass pollen. He was subsequently started on SCIT to grass pollen and developed recurrence of symptoms of EoE—a phenomenon that has yet to be reported in the medical literature.

  • immunological products and Vaccines
  • ear, nose and throat
  • immunology
  • paediatrics
  • unwanted effects / adverse reactions
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  • Contributors AF had the concept for the paper and was involved with acquisition of data and review of the manuscript. RW acquired data and wrote the manuscript. MF was involved with the conception and review of manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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