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I’m currently a junior in high school and I would love to pursue being a comercial pilot as a career.

The thing is I have a medical condition called EoE. It’s basically when I eat something I’m allergic to, my esophagus swells up.

I’m currently treating it with dupixent injections. (1x a week)

Could having this medical condition stop me from getting my medical certificate?

Thank you,

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    $\begingroup$ Here is a case study from the Federal Air Surgeon's Medical Bulletin 16-2, beginning on page 9 regarding EoE that might provide you some insight. Click Here $\endgroup$
    – user22445
    Oct 31, 2023 at 1:52
  • $\begingroup$ @RTO With the relevant part quoted, that would make a good answer. $\endgroup$
    – Jamiec
    Oct 31, 2023 at 9:01

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I have EoE that I am treating weekly with dupixent, and have a special issuance for a 3rd class medical. It's unlikely to be a problem as long as you have no side effects, but you can expect that the FAA will take some time to make a decision.

Monoclonal antibodies like dupixent require a special issuance with annual monitoring. Basically every year you will need to mail some clinical notes to the AMCD that says dupixent has still not made you blind or anything.

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  • $\begingroup$ Thank you for your response. How long did it take you to get the 3rd class medical including the special issuance? Also how much did the whole process cost you? Thank you, $\endgroup$
    – CoolPilot
    Oct 31, 2023 at 16:02
  • $\begingroup$ @CoolPilot Just the cost of the third class physical. The FAA just wanted me to mail them some info from my doctors. I already had been the the doctor recently enough that they accepted letters from them without requiring another visit. It took several months for the FAA to make a decision, and my special issuance requires annual updates from my doctors. $\endgroup$
    – anonymous
    Nov 1, 2023 at 1:50
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According to this airman case report from the Federal Air Surgeon's Medical Bulletin 16-2, page 9:

"EoE" (Eosinophilic Esophagitis) is an immune-mediated dysfunction of the esophagus secondary to eosinophils in the esophageal mucosa. Symptoms range from asymptomatic to nausea, vomiting, chest pain, or dysphagia. Acutely, EoE can be associated with esophageal food impaction and the inability to swallow saliva. Any of these symptoms can cause a safety of flight issue.

Also, § 67.113 General medical condition. (pertinent portion - 67.113.b.1 - of this regulation was stated in the case report referenced above)

The general medical standards for a first-class airman medical certificate are:

[...]

(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds—

(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or

(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

After initially being denied a medical certificate, the airman who was the subject of the case report, saw an allergist, took prescribed medication, had a third esophageal dilation performed, and changed his diet. His symptoms eventually resolved and he was subsequently issued a first-class medical certificate.

A first-class medical certificate is required when exercising the pilot-in-command privileges of an Airline Transport Pilot certificate (ATP), which, in the U.S., is the highest level pilot certificate issued by the FAA and is necessary if you wish to eventually be an "airline" captain.

So, it appears in some circumstances, for a person wishing to hold an FAA pilot certificate with an associated medical certificate who has "EoE" there is a pathway as illustrated in the linked case report above.

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