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2019, Number 5

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Cir Cir 2019; 87 (5)

Acute dysphagia presentation and its association with esophagitis dissecans and concomitant diseases. A diagnostic challenge

Teramoto-Matsubara, Óscar; Galvis-García, Elymir S; Abdo-Francis, Juan M; Sobrino-Cossío, Sergio; Orozco-Gamiz, Antonio; Morales-Arámbula, Miguel; Carrasco-Rojas, J Antonio; Meza-Caballero, Marisi

Language: Spanish
References: 45
Page: 572-579
PDF size: 530.58 Kb.


ABSTRACT

Esophagitis dissecans (ESD) is an uncommon disease that is associated with eosinophilic esophagitis (EoE), candidiasis and/ or drugs. We aim to characterize the clinical, endoscopic and histological damage of the mucosal in subjects with dysphagia, its relation to concomitant entities and the treatment response. This is a retrospective observational study in patients with dysphagia and esophageal mucosal damage We included 23 patients (mean age = 55 years) who had GERD symptoms, dysphagia and/or odynophagia. There were 10, 9 and 4 cases of esophagitis dissecans, desquamative/esfacelante (ESD/ES) and fibrostenotic, respectively. ESD/SE is a rare entity with variable clinical, endoscopic and histological spectrum. The association with GERD was frequent.


REFERENCES

  1. Blevins CH, Iyer PG, Vela MF, Katzka DA. The esophageal epithelial barrier in health and disease. Clin Gastroenterol Hepatol. 2018;16:608-17.

  2. Jiménez P, Lanas A, Piazuelo E, et al. Effect of growth factors and prostaglandin E2 on restitution and proliferation of rabbit esophageal epithelial cells. Dig Dis Sci. 1998;43:2309-16.

  3. Jiménez P, Lanas A, Piazuelo E, et al. Effects of extracellular pH on restitution and proliferation of rabbit oesophageal epithelial cells. Aliment Pharmacol Ther. 1999;13 545-52.

  4. Shen L. Tight junctions on the move: molecular mechanisms for epithelial barrier regulation. Ann N Y Acad Sci. 2012;1258:9-18.

  5. Souza RF, Huo X, Mittal V, et al. Gastroesophageal reflux might cause esophagitis through a cytokine-mediated mechanism rather than caustic acid injury. Gastroenterology. 2009;137:1776-84

  6. Honda J, Iijima K, Asanuma K, et al. Estrogen enhances esophageal barrier function by potentiating occludin expression. Dig Dis Sci. 2016;61:1028-38.

  7. Álvaro-Villegas JC, Sobrino-Cossío S, Hernández-Guerrero A, et al. Dilated intercellular spaces in subtypes of gastroesophagic reflux disease. Rev Esp Enferm Dig. 2010;102:302-7.

  8. Green A, Streutker CJ. Esophagitis: old histologic concepts and new thoughts. Arch Pathol Lab Med. 2015;139:723-9.

  9. Krugmann J, Neumann H, Vieth M, Armstrong D. What is the role of endoscopy and oesophageal biopsies in the management of GERD? Best Pract Res Clin Gastroenterol. 2013;27:373-85.

  10. Fiocca R, Mastracci L, Riddell R, et al. Development of consensus guidelines for the histologic recognition of microscopic esophagitis in patients with gastroesophageal reflux disease: the Esohisto project. Hum Pathol. 2010;41:223-31.

  11. Dellon ES, Gonsalves N, Hirano I, Furuta GT, Liacouras CA, Katzka DA. ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol. 2013;108 679-92.

  12. Hirano I, Aceves SS. Clinical implications and pathogenesis of esophageal remodeling in eosinophilic esophagitis. Gastroenterol Clin North Am. 2014;43:297-316.

  13. Parfitt JR, Gregor JC, Suskin NG, Jawa HA, Driman DK. Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients. Mod Pathol. 2006;19:90-6.

  14. Gentile N, Katzka D, Ravi K, Trenkner S, Enders F, Killian J, et al. Oesophageal narrowing is common and frequently under-appreciated at endoscopy in patients with oesophageal eosinophilia. Aliment Pharmacol Ther. 2014;40:1333-40.

  15. Lee J, Huprich J, Kujath C, et al. Esophageal diameter is decreased in some patients with eosinophilic esophagitis and might increase with topical corticosteroid therapy. Clin Gastroenterol Hepatol. 2012;10:481-6.

  16. Kwiatek MA, Hirano I, Kahrilas PJ, Rothe J, Luger D, Pandolfino JE. Mechanical properties of the esophagus in eosinophilic esophagitis. Gastroenterology. 2011;140:82-90.

  17. Moawad FJ, Robinson CL, Veerappan GR, Summers TA, Maydonovitch CL, Wong RKH. The tug sign: an endoscopic feature of eosinophilic esophagitis. Am J Gastroenterol. 2013;108:1938-9.

  18. Chehade M, Sampson HA, Morotti RA, Magid MS. Esophageal subepithelial fibrosis in children with eosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2007;45:319-28.

  19. Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128:3-20.

  20. Dellon ES. Epidemiology of eosinophilic esophagitis. Gastroenterol Clin North Am. 2014;43:201-18.

  21. Tutuian R. Adverse effects of drugs on the esophagus. Best Pract Res Clin Gastroenterol. 2010;24:91-7.

  22. De Petris G, Gatius Caldero S, Chen L, et al. Histopathological changes in the gastrointestinal tract due to drugs: an update for the surgical pathologist (part I of II). Int J Surg Pathol. 2014;22:120-8.

  23. Wilcox CM, Schwartz DA. Endoscopic-pathologic correlates of Candida esophagitis in acquired immunodeficiency syndrome. Dig Dis Sci. 1996;41:1337-45.

  24. Maguire A, Sheahan K. Pathology of oesophagitis. Histopathology. 2012;60:864-79.

  25. Almashat SJ, Duan L, Goldsmith JD. Non-reflux esophagitis: a review of inflammatory diseases of the esophagus exclusive of reflux esophagitis. Sem Diagn Path. 2014;31:89-99.

  26. Hart PA, Romano RC, Moreira RK, Ravi K, Sweetser S. Esophagitis dissecans superficialis: clinical, endoscopic, and histologic features. Dig Dis Sci. 2015;60:2049-57.

  27. Carmack SW, Vemulapalli R, Spechler SJ, Genta RM. Esophagitis dissecans superficialis (“sloughing esophagitis”): a clinicopathologic study of 12 cases. Am J Surg Pathol. 2009;33:1789-94.

  28. Purdy JK, Appelman HD, McKenna BJ. Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophageal mucosa. Mod Pathol. 2012;25:767-75.

  29. Ma Ch, et al. Recently highlighted non-neoplastic pathologic entities of their upper GI tract and their clinical significance. Gastrointest Endosc. 2014;80:960-5.

  30. Rosenberg B. Oesophagitis dissecans superficialis. Centralbl Allg Pathol u Path Anat. 1892;3:753-9.

  31. Chen WC, et al. Desquamative esophagitis: a refractory mucosal injury pattern. Dis Esophagus. 2017;30:1-5.

  32. Abbass K, Haveman L, Gertner E. Esophagitis dissecans superficialis due to severe methotrexate toxicity. Endoscopy. 2014;46(Suppl 1): E99-100.

  33. Cameron RB. Esophagitis dissecans superficialis and alendronate: case report. Gastrointest Endosc. 1997;46:562-3.

  34. Hokama A, Ihama Y, Nakamoto M, Kinjo N, Kinjo F, Fujita J. Esophagitis dissecans superficiales associated with bisphosphonates. Endoscopy. 2007;39(Suppl 1):E91.

  35. De Petris G, Gatius Caldero S, et al. Histopathological changes in the gastrointestinal tract due to medications: an update for the surgical pathologist (part II of II). Int J Surg Pathol. 2013;22:202-11.

  36. Pérez-Carreras M, Castellano G, Colina F, et al. Esophagitis dissecans superficialis (esophageal cast) complicating esophageal sclerotherapy. Am J Gastroenterol. 1998;93 655-6.

  37. Hokama A, Yamamoto Y, Taira K, et al. Esophagits dissecans superficialis and autoimmune bullous dermatoses: a review. World J Gastrointest Endosc. 2010;2:252-6.

  38. Shih A, Misdraji J. Drug-induced pathology of the upper gastrointestinal tract. Diagnostic Histopathology. 2017;23:84-95.

  39. Zografos GN, Georgiadou D, Thomas D, et al. Drug-induced esophagitis. Dis Esophagus. 2009;22:633e7.

  40. Zehou O, Raynaud JJ, Roux-Villet L, Alexandre M, Airinei G, Pascal F, et al. Oesophageal involvement in 26 consecutive patients with mucous membrane pemphigoid. Br J Dermatol. 2017;177:1074-85.

  41. Hage-Nassar G, Rotterdam H, Frank D, et al. Esophagitis dissecans superficialis associated with celiac disease. Gastrointest Endosc. 2003; 57:140-1.

  42. Morgenstern M. Tube-like expulsion of esophageal mucosa (esophagitis exfoliativasive dissecans superficialis). Zentralbl Allg Pathol 1952;89: 17-22.

  43. Kurian A, Haber R. Methotrexate-induced cutaneous ulcers in a nonpsoriatic patient: case report and review of the literature. J Cutan Med Surg. 2011;15:275-9.

  44. Albert DM, Ally MR, Moawad FJ. The sloughing esophagus: a report of five cases. Am J Gastroenterol. 2013;108(11), 1816-7.

  45. Brandt L. Esophagitis dissecans superficialis. Gastrointest Endosc. 2011; 74:403-4.




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