case_images: PMC10985185_01
case_images: (A) Dense intraepithelial infiltration of eosinophils with formation of micro-abscesses. Dilated intracellular spaces are evident. HE 400x. (B) Slides after stopping sublingual immunotherapy reveal marked reduction of eosinophils and intercellular edema. HE 400x.
case_images: fped-12-1379162-g001.jpg
case_images: PMC10985185_01_fped-12-1379162-g001.jpg
case_images: F1
case_images: Histopathologic examination revealed severe eosinophilic predominant inflammation with infiltration of about 100 eos/HPF in nearly all biopsies, consistent with the diagnosis of EoE (Figure 1A). One month after SLIT discontinuation, upper gastrointestinal endoscopy showed a normal esophageal mucosa with a diffuse decrease of eosinophilic infiltration (5-10 eos/HPF), and only one specimen still consistent with EoE diagnosis (21 eos/HPF) (Figure 1B).
case_images: Timeline from the episode of care.
case_images: fped-12-1379162-g002.jpg
case_images: PMC10985185_01_fped-12-1379162-g002.jpg
case_images: F2
case_images: After 7 weeks of treatment, the patient underwent a second upper gastrointestinal endoscopy that revealed the persistence of linear furrowing and eosinophilic infiltration (>100 eos/HPF) (Figure 2). Eight weeks later, upper gastrointestinal endoscopy showed an unchanged macroscopic aspect and the persistence of eosinophilic infiltration (>100 eos/HPF) (Figure 2). During a follow-up of 15 months, the patient remained free of any esophageal symptoms and his family refused further endoscopic control (Figure 2).