Eosinophilic Esophagitis during Milk Oral Immunotherapy in a Child with Severe IgE-Mediated CMPA:  A Case Report

Sara Moujtahid; Said Ettair

doi:10.9734/jsrr/2025/v31i103632

Research Article Open access CC BY 4.0

Eosinophilic Esophagitis during Milk Oral Immunotherapy in a Child with Severe IgE-Mediated CMPA: A Case Report

Sara Moujtahid, Said Ettair

Journal of Scientific Research and Reports · pp. 879–884 · Published 23 Oct 2025

10.9734/jsrr/2025/v31i103632

Abstract

Background: Oral immunotherapy (OIT) for persistent cow’s milk protein allergy (CMPA) can improve protection against accidental exposures, but gastrointestinal adverse events, including eosinophilic esophagitis (EoE), are increasingly recognized. Case: A 4.5-year-old boy with severe IgE-mediated CMPA and atopy began milk OIT. After 6 weeks he developed odynophagia, dysphagia, vomiting, anorexia, and weight stagnation. Diagnosis & Treatment: Upper endoscopy showed EoE with peak 78 eosinophils/high-power field (eos/HPF). A strict milk-free diet, proton-pump inhibitor, and swallowed topical budesonide were initiated. Outcome: Symptoms resolved with weight catch-up; follow-up biopsies at 3 months showed remission (3 eos/HPF). Conclusion: In high-risk, highly atopic children, OIT warrants close clinical and endoscopic monitoring. When EoE is suspected, guideline-based evaluation (EREFS, ≥6 biopsies from ≥2 levels) and early anti-inflammatory therapy are recommended.

Cow’s milk protein allergy oral immunotherapy eosinophilic esophagitis child atopy

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Sara Moujtahid, Said Ettair (2025). Eosinophilic Esophagitis during Milk Oral Immunotherapy in a Child with Severe IgE-Mediated CMPA: A Case Report. Journal of Scientific Research and Reports , 879–884. https://doi.org/10.9734/jsrr/2025/v31i103632

Affiliations

Sara Moujtahid — Department of Pediatric Gastroenterology and Hepatology, Children's Hospital of Rabat, Ibn Sina University Hospital of Rabat, Morocco.
Said Ettair — Department of Pediatric Gastroenterology and Hepatology, Children's Hospital of Rabat, Ibn Sina University Hospital of Rabat, Morocco.

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