The following is a summary of “Oral Immunotherapy and Risk of Eosinophilic Esophagitis in Children: 15 Years’ Experience,” published in the January 2023 issue of Gastroenterology and Nutrition by Morales-Cabeza, et al.

Concerns concerning the safety of oral immunotherapy (OIT), which was a successful treatment for kids with recurrent food allergies, including eosinophilic esophagitis (EoE). For a study, researchers sought to assess the prevalence of EoE in a sizable cohort of kids who received OIT at their facility and to look for any clinical, endoscopic, or histologic variations based on the kind of food used for the procedure.

Over the course of 15 years, a retrospective investigation was carried out (2005–2020). Children who underwent OIT for EoE after consuming cow’s milk (CM), eggs, or peanuts were included.

A total of 637 OITs were performed (277 CM-OIT, 322 egg-OIT, and 8 peanut-OIT). A confirmed histologic diagnosis of EoE was present in 17 individuals (2.8%); the diagnosis was more common in patients who received CM-OIT (3.9%) than egg-OIT (2.2%). After the build-up phase of the OIT was finished, symptoms indicative of EoE and a confirmed diagnosis appeared at median periods of 25 and 36 months, respectively. The most typical symptoms were dysphagia, stomach discomfort, and choking. Lamina propria fibrosis was seen in 41.2% of patients. There were no discernible changes between patients receiving CM or egg-OIT regarding their clinical complaints, endoscopic or histologic results. Before the OIT, one-third of the patients had minor EoE-suggestive symptoms.

Even years after OIT, EoE appeared to be an uncommon but significant adverse occurrence. The primary technique for an early diagnosis may be validated questionnaires to screen for EoE before OIT and in the follow-up of the individuals.

Reference: journals.lww.com/jpgn/Abstract/2023/01000/Oral_Immunotherapy_and_Risk_of_Eosinophilic.11.aspx