Eosinophilic esophagitis due to red yeast rice (Monacoline K) in a dietary supplement for hypercholesterolemia

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We present a case of eosinophilic esophagitis (EoE) with positive skin-prick testing for type I allergy to red yeast rice (RYR, Artechol®). RYR is an over-the-counter supplement for hypercholesterolemia, since years famous in Asian countries and now also more and more popular in Western countries. The clinical relevance of IgE-mediated inflammation was proven by a rapid clearance of EoE-symptoms upon discontinuation of RYR. The role of skin-prick testing and allergy testing in general in EoE is controversial, but was of high importance in our patient. It demonstrates that in cases of a clear-cut allergy history, together with positive skin-prick (IgE) testing, a broad elimination diet can thus be avoided.

Original languageEnglish
Pages (from-to)407-409
Number of pages3
JournalJournal of Clinical Gastroenterology
Issue number2
Early online date1 Jan 2021
Publication statusPublished - Apr 2021


  • Eosinophilic esophagitis
  • Hypercholesterolemia
  • Monacoline K
  • Red yeast rice
  • Skin-prick


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