Background Although pollen allergy is a very frequent finding in patients with eosinophilic esophagitis (EoE), it was doubted that it was an etiological agent to consider. Many EoE patients present rhinoconjunctivitis, atopic dermatitis and associated asthma, in addition to dysphagia and food impaction. EoE exacerbations are often seasonal. Methods We performed a real life study. Allergens involved in EoE were identified by prick, specific IgE and component resolved diagnosis (CRD) by microarrays. We selected 255 patients suffered from esophagitis with seasonal exacerbation, and performed a trial with specific immunotherapy with the detected pollen and avoidance of food, if was also detected. Microscopic examination of esophageal biopsies of patients with EoE were made to verify the presence of callose (polysaccharide abundant in the polinic tubes during germination, but absent in animal tissues) in the esophagus. Callose was detected using histological sections stained with sirofluor fluorochrome. Endoscopy and biopsy were performed ever six months of treatment. Esophageal mucosal sections were analyzed by scanning electron microscope Results Diagnosis of allergen hypersensitivity using molecular microarray analysis CRD and biopsy study was more efficient in esophagitis than other tests and was useful to decide the treatment (avoidance or targeted immunotherapy) and allowed us a more reasonable restriction of food in the diet and specific immunotherapy aimed at the suspected allergens responsible for the disease. After immunotherapy, 188 (74%) patients were discharged whit negative biopsy, no symptoms, no medication, without relapse Conclusion Specific immunotherapy achieved clinic resolution and objective improvement by normal biopsy.
