Chest pain in an aspirin-sensitive asthmatic patient. Eosinophilic esophagitis causing esophageal dysmotility.
We describe a case of eosinophilic esophagitis in a 38-year-old man with aspirin-sensitivity asthma which presented as noncardiac chest pain. Manometric measurements demonstrated tertiary contractions. Biopsies showed a dense eosinophilic infiltrate in the mucosa. There was no response to therapy for reflux. Symptoms quickly resolved with corticosteroid therapy. Subsequent manometric values recorded after corticosteroid therapy showed resolution of the dysmotility. Biopsies showed normal mucosa. Adult asthmatic subjects with noncardiac chest pain should receive further investigation if reflux therapy fails to resolve the symptoms.
Hempel
S L
SL
Department of Veterans Affairs Medical Center, Iowa City, USA.
Elliott
D E
DE
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001241:Aspirin / Q000009:adverse effects; D001249:Asthma / Q000150:complications; D002637:Chest Pain / Q000209:etiology*; D004802:Eosinophilia / Q000150:complications* / Q000473:pathology; D015154:Esophageal Motility Disorders / Q000209:etiology*; D004941:Esophagitis / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008365:Manometry
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin