title: Eosinophilic Esophagitis in Two Patients with Systemic Sclerosis.
abstract: The gastrointestinal tract (GIT) is the most common extracutaneous organ system damaged in systemic sclerosis (SSc) and is the presenting feature in 10% of patients. The esophagus as the portion of the GIT is the most commonly affected and there is an association of gastroesophageal reflux (GER) with SSc interstitial lung disease (ILD). Thus, an aggressive treatment for GER is recommended in all SSc patients with ILD; however, it is recognized that a long-term benefit to this treatment is needed to understand its impact. In this case report we discuss the presence of eosinophilic esophagitis (EoE) in two SSc patients and discuss the role for early EGD in SSc patients with moderate-severe GER symptoms for tissue study. Assessment of esophageal biopsy specimens for the presence of eosinophils and possibly ANA can help elucidate disease pathogenesis and direct therapy, as the presence of EoE in SSc has important management considerations, particularly with regards to dietary modification strategies.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, University of Utah School of Medicine, 4B200 30 N. 1900 E., Salt Lake City, UT 84132, USA.
authors.forename: Tracy M
authors.initials: TM
authors.lastname: Frech
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Boynton
authors.affiliation: Department of Anatomic Pathology, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA.
authors.forename: Erinn
authors.initials: E
authors.lastname: Downs-Kelly
authors.affiliation: Department of Ophthalmology, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Jones
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Kriesel
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Peterson