{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:24:48Z","timestamp":1787027088857,"version":"build-2736575974"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammation of the esophagus, characterized by symptoms related to esophageal dysfunction, resulting from severe eosinophilic infiltration of the esophageal mucosa. It is common in atopic subjects and food antigens have been identified as the most common triggers. However, a seasonal variation in EoE prevalence, correlated with air pollen levels, is reported, suggesting that also aeroallergens may play a role. Little is known about the interplay between EoE and concomitant atopy treatment for aeroallergens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We describe the case of an 11-year-old boy who presented dysphagia, vomiting, drooling, and chest pain while eating meat, developed 15 months after receiving sublingual immunotherapy (SLIT) for Alternaria (SUBLIVAC\u00ae). He underwent esophagogastroduodenoscopy (EGD) revealing severe eosinophilic predominant inflammation (100 eos\/HPF), consistent with the diagnosis of EoE, not improving at the EGDs performed after both omeprazole and topical corticosteroids treatment, despite symptom improvement. Afterward, immunotherapy was switched from sublingual to injective form. At the EGD performed 1 month later, macroscopic examination of the esophageal mucosa was normal and eosinophilic infiltration was significantly decreased (5\u201310 eos\/HPF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SLIT may induce EoE by chronic antigenic exposure of oral mucosa in patients with a robust allergic susceptibility: while attenuating the IgE-mediated immune reactions, the progressive contact with the causative allergen might induce a chronic stimulation of the immune system with the consequent activation of tissue eosinophils. Our data suggest monitoring patients receiving SLIT for EoE symptoms and to discontinue SLIT on their earlier appearance, possibly as a first-line treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2024.1379162","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:38:08Z","timestamp":1710808688000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Eosinophilic esophagitis improved by the discontinuation of sublingual immunotherapy for aeroallergens: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Alice","family":"Monzani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Cerutti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Curto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Lovaste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Coppola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mercalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Saettone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Rabbone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1177\/2050640616689525","article-title":"Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults","volume":"5","author":"Lucendo","year":"2017","journal-title":"United Eur Gastroenterol J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/j.anai.2014.08.004","article-title":"Relation between eosinophilic esophagitis and oral immunotherapy for food allergy: a systematic review with meta-analysis","volume":"624","author":"Lucendo","year":"2014","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1159\/000457796","article-title":"Oral and sublingual immunotherapy: potential causes for eosinophilic gastrointestinal disorders?","volume":"172","author":"Babaie","year":"2017","journal-title":"Int Arch Allergy Immunol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.anai.2018.12.013","article-title":"Seasonal exacerbation of eosinophilic esophagitis histologic activity in adults and children implicates role of aeroallergens","volume":"122","author":"Reed","year":"2019","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1007\/s12328-021-01520-5","article-title":"A case series of sublingual immunotherapy-induced eosinophilic esophagitis: stop or spit","volume":"14","author":"Fujiwara","year":"2021","journal-title":"Clin J Gastroenterol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/j.alit.2018.03.003","article-title":"Development of eosinophilic esophagitis following sublingual immunotherapy with cedar pollen extract: a case report","volume":"67","author":"Kawashima","year":"2018","journal-title":"Allergol Int"},{"key":"B7","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/j.anai.2016.03.017","article-title":"Eosinophilic esophagitis after desensitization to dust mites with sublingual immunotherapy","volume":"116","author":"B\u00e9n\u00e9","year":"2016","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.anai.2017.05.004","article-title":"Eosinophilic esophagitis induced by aeroallergen sublingual immunotherapy in an enteral feeding tube-dependent pediatric patient","volume":"88","author":"Rokosz","year":"2017","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"bcr2017223465","DOI":"10.1136\/bcr-2017-223465","article-title":"Recurrence of eosinophilic oesophagitis with subcutaneous grass pollen immunotherapy","volume":"2018","author":"Wells","year":"2018","journal-title":"BMJ Case Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.3390\/children10101620","article-title":"A practical update on pediatric eosinophilic esophagitis","volume":"10","author":"Votto","year":"2023","journal-title":"Children (Basel)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1097\/MCG.0000000000000878","article-title":"Efficacy of pharmacologic therapy for eosinophilic esophagitis: a systematic review and network meta-analysis","volume":"52","author":"Tomizawa","year":"2018","journal-title":"J Clin Gastroenterol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12533","article-title":"Swallowed topical corticosteroids for eosinophilic esophagitis: utilization and real-world efficacy from the EoE CONNECT registry","author":"Laserna-Mendieta","year":"2024","journal-title":"United Eur Gastroenterol J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1111\/j.1365-2222.2005.02219.x","article-title":"Post-marketing survey on the safety of sublingual immunotherapy in children below the age of 5 years","volume":"35","author":"Rienzo","year":"2005","journal-title":"Clin Exp Allergy"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1016\/j.jaci.2015.03.004","article-title":"Pediatric eosinophilic esophagitis symptom scores (PEESS v2.0) identify histologic and molecular correlates of the key clinical features of disease","volume":"135","author":"Martin","year":"2015","journal-title":"J Allergy Clin Immunol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1097\/ACI.0000000000000537","article-title":"Eosinophilic esophagitis during sublingual and oral allergen immunotherapy","volume":"19","author":"Cafone","year":"2019","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s11882-018-0798-2","article-title":"What is the relationship between eosinophilic esophagitis (EoE) and aeroallergens? Implications for allergen immunotherapy","volume":"18","author":"Egan","year":"2018","journal-title":"Curr Allergy Asthma Rep"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1379162\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:38:10Z","timestamp":1710808690000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1379162\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,19]]},"references-count":16,"alternative-id":["10.3389\/fped.2024.1379162"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1379162","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,19]]},"article-number":"1379162"}}