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Eosinophilic gastroenteritis presenting as achalasia cardia and responding to botulinum injection and therapy directed against eosinophilic esophagitis

  • Akash Mathur
  • Kaustubh Mundada
  • Abhai Verma
  • Vinita Agrawal
  • Vikrant Verma
  • Uday C. GhoshalEmail author
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A 27-year-old female presented with dysphagia, regurgitation, and weight loss (15 kg) for 4 months. Examination revealed severe malnutrition (body mass index 10.3 kg/m 2) and pallor. An esophagoduodenoscopy revealed a dilated esophagus and resistance at the gastroesophageal junction. A timed barium esophagogram showed hold up of contrast with distal tapering (Fig.  1a–c). The diagnosis of type II achalasia was confirmed on high-resolution solid state (Sandhill Scientific, CO, USA) esophageal manometry (basal lower esophageal sphincter [LES] pressure 25 mmHg, integrated relaxation pressure [IRP] 66 mmHg, distal contractile integral [DCI] 1155 mmHg/cm/s) (Fig. 1d). In view of the short duration of symptoms and severe weight loss, a positron emission tomographic (PET) scan performed with a possibility of secondary achalasia showed metabolically active enhancing mucosal thickening in the entire colon without any fluorodeoxyglucose (FDG) avidity in the esophagus. Her fecal calprotectin was...

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Conflict of interest

AM, KM, AV, VA, VV, and UCG declare that they have no conflict of interest.

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The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.

References

  1. 1.
    Spechler S, Konda V, Souza R. Can eosinophilic esophagitis cause achalasia and other esophageal motility disorders? Am J Gastroenterol. 2018;113:1594–9.CrossRefGoogle Scholar
  2. 2.
    Alfadda A, Storr M, Shaffer E. Eosinophilic colitis: epidemiology, clinical features, and current management. Ther Adv Gastroenterol. 2010;4:301–9.CrossRefGoogle Scholar
  3. 3.
    Mandaliya R, DiMarino A, Cohen S. Association of achalasia and eosinophilic esophagitis. Indian J Gastroenterol. 2013;32:54–7.CrossRefGoogle Scholar

Copyright information

© Indian Society of Gastroenterology 2020

Authors and Affiliations

  • Akash Mathur
    • 1
  • Kaustubh Mundada
    • 1
  • Abhai Verma
    • 1
  • Vinita Agrawal
    • 1
  • Vikrant Verma
    • 1
  • Uday C. Ghoshal
    • 1
    Email author
  1. 1.Departments of Gastroenterology and PathologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

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