An Uncommon Cause of Dysphagia

Oncology, Gastroenterology and Hepatology Reports,2019,8,1,01-02.
Published:June 2019
Type:Original Article
Authors:
Author(s) affiliations:

Lara Aboud Syriani1*, Liat Gutin1, Ryan Gill2, Najwa El-Nachef3

1Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

2Department of Pathology, University of California, San Francisco, San Francisco, CA, USA

3Division of Gastroenterology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

Abstract:

Dysphagia is a frequent indication for a referral to a gastroenterologist. The most common etiologies of dysphagia include gastroesophageal reflux disease, eosinophilic esophagitis (EoE), or structural disorders of the esophagus. We present a case of refractory dysphagia in a patient with a history of Sjogren’s disease and autoimmune hepatitis. Upper endoscopy showed crepe paper appearance of the esophagus raising suspicion for EoE; however, biopsies revealed lymphocytic esophagitis (LE). As LE is a rare entity, optimal treatment remains unknown. Nonetheless, applying the common methods used to treat EoE including proton pump inhibitors, topical steroids, and esophageal dilations improved the patient’s symptoms.

Endoscopic appearance at diagnosis showing esophageal narrowing at 25cm