title: Peroral endoscopic myotomy for treatment of Guillain-Barre syndrome-associated achalasia: A rare case.
abstract: Guillain-Barre syndrome (GBS)-associated achalasia is a very rare disease of uncertain cause. We report the case of a patient diagnosed with GBS-associated type I achalasia who was successfully treated with peroral endoscopic myotomy (POEM). A 30-year-old man who was diagnosed with GBS 3 mo before was referred to our department with dysphagia and meal-related regurgitation. The results of esophagography, endoscopy, and high-resolution manometry (HRM) revealed type I achalasia. POEM that utilized a submucosal tunneling technique was performed to treat the GBS-associated type I achalasia. After POEM, smooth passage of a contrast agent into the stomach was shown in follow-up esophagography, and follow-up HRM revealed a decrease in the mean integrated relaxation pressure 22.9 mmHg to 9.6 mmHg. The patient remained without dysphagia for 7 mo, even though the patient's neurological problems were not fully resolved. POEM may be a safe and effective treatment for GBS-associated type I achalasia.
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Seung Kak
authors.initials: SK
authors.lastname: Shin
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Kyoung Oh
authors.initials: KO
authors.lastname: Kim
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Eui Joo
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Su Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Yoon Jae
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Chung
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Kwang An
authors.initials: KA
authors.lastname: Kwon
authors.affiliation: Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea.
authors.forename: Dong Kyun
authors.initials: DK
authors.lastname: Park
mesh_terms: D000328:Adult; D004931:Esophageal Achalasia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology; D004945:Esophagoscopy / Q000379:methods; D020275:Guillain-Barre Syndrome / Q000150:complications*; D006801:Humans; D008297:Male; D008365:Manometry; D011312:Pressure
keywords: Achalasia; Guillain-Barre syndrome; Peroral endoscopic myotomy