title: Rare coincidence of eosinophilic esophagitis with esophageal stenosis and intramural pseudodiverticulosis.
abstract: We describe the first detailed case of eosinophilic esophagitis associated with esophageal intramural pseudodiverticulosis and gastro-esophageal reflux disease in a 24-year-old man, who suffered from recurrent dysphagia since the age of 3 years. He presented with symptoms of dysphagia, food impaction and malnutrition. An esophagogram revealed a high-grade stenosis in the proximal part of the esophagus. Histological evaluation of esophageal mucosal biopsies demonstrated more than 20 eosinophil granulocytes per high power field, indicative of eosinophilic esophagitis. Additionally, esophago-gastro-duodenoscopy showed pseudodiverticulosis in the distal portion of the esophagus. A therapeutic regimen consisting of topical steroid intake, antihistamines, proton-pump-inhibition and specific food avoidance led to significant clinical improvement within 6 weeks.
authors.affiliation: First Department of Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Ulmenweg 18, D-91054 Erlangen, Germany. matthias.engel@med1.imed.uni-erlangen.de
authors.forename: M A
authors.initials: MA
authors.lastname: Engel
authors.forename: M
authors.initials: M
authors.lastname: Raithel
authors.forename: K
authors.initials: K
authors.lastname: Amann
authors.forename: H
authors.initials: H
authors.lastname: Greess
authors.forename: E G
authors.initials: EG
authors.lastname: Hahn
authors.forename: P C
authors.initials: PC
authors.lastname: Konturek
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002404:Catheterization; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004936:Diverticulum, Esophageal / Q000150:complications* / Q000175:diagnosis; D004802:Eosinophilia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004940:Esophageal Stenosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004941:Esophagitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000068298:Fluticasone; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008365:Manometry
chemical_list: D000730:Androstadienes; D018926:Anti-Allergic Agents; D000068298:Fluticasone