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Topical steroid therapy for eosinophilic esophagitis

Question:

3/19/2020
I have a 20 year-old male referred by GI for EOE. He presented with food impactions and has already had 2 scopes. Second EGD after initiation of Pantoprazole 40mg daily. Both EGDs had > 60-80 EOS/HPF. He has no interest in trying even a two food elimination diet at this time. Would it be appropriate to start Flovent 220 therapy during this Coronavirus pandemic? Will the high dose topical steroid given orally even with good rinsing of the mouth put this young man a greater risk for more severe disease if he were exposed to the virus?

Answer:
There will be minimal systemic steroid exposure using swallowed topical steroids for eosinophilic esophagitis. This should lead to minimal risk of worsening COVID-19 outcome if infected.

https://www.jgld.ro/jgld/index.php/jgld/article/view/768/336

Eric Macy MD MS FAAAAI