SHM Converge Scientific Abstract ePoster Gallery-A Rare Intersection of Hypereosinohilic Disease: Coexistence of Eosinophilic Esophagitis and Abpa in a Patient With Asthma

A Rare Intersection of Hypereosinohilic Disease: Coexistence of Eosinophilic Esophagitis and Abpa in a Patient With Asthma

Back to course

Pdf Summary

This case report describes a rare coexistence of eosinophilic esophagitis (EoE) and allergic bronchopulmonary aspergillosis (ABPA) in a 49-year-old woman with asthma. She initially presented with dysphagia and food bolus impaction, and endoscopy was suspicious for EoE. She returned the next day with abdominal pain and worsening shortness of breath, along with marked eosinophilia (absolute eosinophil count 2,500/µL).<br /><br />Imaging showed patchy bilateral airspace disease on chest X-ray and CT findings of multifocal cystic bronchiectasis with tubular nodules consistent with mucus impaction. Although she had reportedly well-controlled asthma, further evaluation revealed elevated total IgE and Aspergillus fumigatus-specific IgE, confirming ABPA. Bronchoscopy showed diffuse airway erythema and secretions, and she was treated with prednisone with clinical improvement. Biopsy later confirmed EoE.<br /><br />The discussion emphasizes that both ABPA and EoE are Th2-mediated, IgE-driven eosinophilic disorders involving cytokines such as IL-4, IL-5, and IL-13. While asthma is a known risk factor for ABPA, coexistence with EoE is uncommon. The case highlights the importance of considering additional hypereosinophilic conditions when one eosinophilic disease is identified. It also underscores the value of imaging in detecting ABPA even when asthma symptoms appear controlled.<br /><br />Overall, the report stresses early recognition of ABPA to prevent progressive bronchiectasis and irreversible lung damage, and it broadens awareness of overlapping eosinophilic disease syndromes.

Asset Subtitle

Paola Campillo

Meta Tag

Author List Ariana Sims, Daniel G. Bosteder, Mark A. Ciraldo, Paola Campillo

Category Clinical Vignettes

Concept Allergic Bronchopulmonary Aspergillosis

Concept Eosinophilic Esophagitis

Concept Eosinophilia

Concept Asthma

Concept Immunoglobulin E

Distinguished Non-Finalist

Presenter Organization BayCare

Presenting Author Paola Campillo

Track Adult

Keywords

eosinophilic esophagitis

allergic bronchopulmonary aspergillosis

ABPA

EoE

asthma

eosinophilia

bronchiectasis

Aspergillus fumigatus

dysphagia

mucus impaction

Allergic Bronchopulmonary Aspergillosis

Eosinophilic Esophagitis

Eosinophilia

Asthma

Immunoglobulin E