Division of Allergology, Department of Rheumatology, Immunology, and Allergology, Inselspital, Bern University Hospital, 3010, Bern, Switzerland.
Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
BMC Gastroenterol. 2020 Dec 11;20(1):419. doi: 10.1186/s12876-020-01554-y.
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease that has been known since the early 1990s. Swallowed topical corticosteroids (STC) belong to the therapeutic cornerstones. We describe a delayed hypersensitivity reaction to Jorveza®, a newly developed orodispersible budesonide tablet licensed for the treatment of eosinophilic esophagitis.
A 32-year-old Caucasian woman with EoE was newly treated with Jorveza®. Hours after the first intake, she felt a "strange pruritus" in the throat. This sensation worsened with each subsequent intake. On day 4 she developed oral mucosal symptoms (paresthesia of the tongue, sore and an itchy throat). Intraoral, throat and facial swellings, but no systemic reaction were observed. Patch testing using two commercial test series as well as the orodispersible budesonide tablet revealed a strong sensitization, proving a T cell mediated allergy to budesonide.
Orodispersible budesonide is increasingly prescribed for the treatment of eosinophilic esophagitis. The development of oropharyngeal symptoms after initiating should alert the treating physician to the possibility of a hypersensitivity reaction.
嗜酸性食管炎（EoE）是一种自 20 世纪 90 年代初以来就为人所知的慢性炎症性疾病。口服皮质类固醇（STC）属于治疗基石。我们描述了一种对 Jorveza®的迟发性超敏反应，Jorveza®是一种新开发的、可口服分散的布地奈德片剂，用于治疗嗜酸性食管炎。
一名 32 岁的白种女性患有 EoE，新接受 Jorveza®治疗。首次摄入后数小时，她感到喉咙“奇怪的瘙痒”。这种感觉随着每次后续摄入而恶化。第 4 天，她出现口腔黏膜症状（舌感觉异常、喉咙痛和瘙痒）。口腔、喉咙和面部肿胀，但无全身反应。使用两个商业测试系列以及可口服分散的布地奈德片剂进行斑贴试验显示强烈致敏，证明对布地奈德存在 T 细胞介导的过敏。
可口服分散的布地奈德越来越多地用于治疗嗜酸性食管炎。开始治疗后出现口咽症状应提醒治疗医生注意发生过敏反应的可能性。
