A patient with odynophagia and unusual endoscopic findings.

Abstract

The case describes a 50-year-old woman presenting with a severe painful dysphagia to solids, impacting on her nutritional intake. She had a history of pemphigus vulgaris maintained in remission with azathioprine, with no evidence of active oral or cutaneous disease at the time of presentation. Endoscopy and histology from the distal oesophagus revealed oesophageal involvement of pemphigus vulgaris. This is a relatively rare clinical form of the disease, with only 58 cases reported worldwide. Patients with pemphigus vulgaris are also prone to infective or steroid-induced gastritis, which present in the same way. Early endoscopic evaluation is therefore essential to distinguish between oesophageal involvement of pemphigus vulgaris and other pathologies, which warrant significant differences in management.

• Authors: Jessica Griffin, Jonathan Potts, Sukhdev Chatu, Guy Chung-Faye
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Nov 26 2015) ISSN: 1757-790X [Electronic] England
• PMID: 26611476 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Chemical References

• Anti-Inflammatory Agents
• Glucocorticoids
• Prednisolone
• Methylprednisolone

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Deglutition Disorders (etiology)
• Esophageal Diseases (complications, drug therapy, pathology)
• Esophagoscopy
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Methylprednisolone (therapeutic use)
• Middle Aged
• Pain (etiology)
• Pemphigus (complications, drug therapy, pathology)
• Prednisolone (therapeutic use)