Esophageal stenosis with sloughing esophagitis: A curious manifestation of graft-vs-host disease.
We report a case of a 56-year-old woman with a history of allogenic bone marrow transplantation for two years, complaining with dysphagia and weight loss. Upper endoscopy revealed esophageal stenosis and extensive mucosa sloughing. Biopsies confirmed the diagnosis of graft-vs-host disease (GVHD). Balloon dilation, corticosteroids and cyclosporin resulted in marked clinical improvement. Gastrointestinal tract is involved in the majority of patients with chronic GVHD. Esophageal manifestations are rare and include vesiculobullous disease, ulceration, esophageal webs, casts or strictures. Sloughing esophagitis along with severe stenosis requiring endoscopic dilation has never been reported in this context.
Daniel Trabulo, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., 2910-446 Setúbal, Portugal.
Daniel
D
Trabulo
Daniel Trabulo, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., 2910-446 Setúbal, Portugal.
Sara
S
Ferreira
Daniel Trabulo, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., 2910-446 Setúbal, Portugal.
Pedro
P
Lage
Daniel Trabulo, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., 2910-446 Setúbal, Portugal.
Rafaela Lima
RL
Rego
Daniel Trabulo, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., 2910-446 Setúbal, Portugal.
Gilda
G
Teixeira
Daniel Trabulo, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal E.P.E., 2910-446 Setúbal, Portugal.
A Dias
AD
Pereira
D001706:Biopsy; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003680:Deglutition Disorders / Q000209:etiology; D004106:Dilatation; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004941:Esophagitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D007166:Immunosuppressive Agents
Balloon dilation; Dysphagia; Esophageal stenosis; Graft-vs-host-disease; Sloughing esophagitis