A case of paediatric seasonal eosinophilic oesophagitis

Eosinophilic esophagitis (EoE) is a chronic disorder characterized by eosinophilic inflammation of the oesophagus triggered by food allergens and possibly aeroallergens. We present a boy with the diagnosis of EoE at the age of 4 years and the disease responded to topical steroids. When he turned 7 years old he had the concomitant diagnose of grass pollen allergy. A clear difference between both histological (October 2019: 0 eosinophils (Eo's)/High Power Field (HPF), April 2022: 80 Eo's/ HPF) and clinical signs (October 2019: pediatric eoe symptom score (PEESS) 3/100, April 2022: PEESS 31/100) is evident when comparing winter to spring. The boy is currently only using topical budesonide during grass pollen season. There are increasing arguments in favour of aeroallergens as a trigger for EoE. This information is important for determining the timing of endoscopic follow-up. And it may be beneficial to consider upgrading treatment during allergy season, or exclusively administering treatment during allergy season.