Abstract
Patient is a 9-year-old male with a history of moderate/severe atopic dermatitis, allergic rhinitis and eosinophilic esophagitis (EoE). He initially presented to an outside gastroenterologist at 3 years of age due to poor growth and picky eating. He had an endoscopy performed, which demonstrated esophageal eosinophilia. At the time of EoE diagnosis, patient was without IgE mediated food allergies, specifically tolerating dairy products regularly without symptoms. His initial management of eosinophilic esophagitis included the 4-food elimination diet. At 7 years of age he presented to our institution for a second opinion. Several months prior to initial consultation, he accidentally ate a cheddar chip and developed immediate orbital angioedema and urticaria, which resolved with Benadryl, indicating a likely IgE mediated allergy to cows milk despite prior tolerance.
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