title: Achalasia-like syndrome as the first manifestation in a patient with CREST syndrome.
abstract: We report a case of oesophageal disease as the first manifestation in a patient with CREST syndrome. A 46-year-old man with achalasia-like syndrome developed CREST syndrome 4 years later. A pneumatic dilatation of the cardia was performed. After pneumatic dilatation the dysphagia and regurgitation disappeared but the patient developed reflux oesophagitis. Four years after diagnosis of oesophageal disease he presented with a clinical picture of CREST syndrome. An acute ileus and constipation developed later. After receiving medical therapy with omeprazole and cisapride the patient is free of oesophageal symptoms and bowel movements are normal. Oesophageal disease is common in patients with limited and diffuse scleroderma, but to our knowledge achalasia-like syndrome has not been previously described as the first manifestation of the systemic disease.
authors.affiliation: Gastroenterology Unit, Hospital La Fe, Valencia, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Garrigues
authors.forename: J
authors.initials: J
authors.lastname: Ponce
authors.forename: C
authors.initials: C
authors.lastname: Gálvez
authors.forename: J
authors.initials: J
authors.lastname: Valverde
authors.forename: J
authors.initials: J
authors.lastname: Berenguer
mesh_terms: D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D017675:CREST Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D002299:Cardia / Q000473:pathology; D020117:Cisapride; D003248:Constipation / Q000175:diagnosis; D004106:Dilatation; D004931:Esophageal Achalasia / Q000175:diagnosis* / Q000628:therapy; D004942:Esophagitis, Peptic / Q000175:diagnosis; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use
chemical_list: D000897:Anti-Ulcer Agents; D010880:Piperidines; D009853:Omeprazole; D020117:Cisapride