P2319 - Russell Body Esophagitis: Food Bolus Leads to Rare Diagnosis

Vijay Kata, MD, Dhaval Patel, DO, Mat Thomas, MD, Dhruv Joshi, DO
Riverside Medical Center, Kankakee, IL

Introduction: Russell Body Esophagitis is an inflammatory condition associated with polyclonal plasma cells within the esophageal mucosa made up of eosinophilic immunoglobulins. It is normally associated with Helicobacter Pylori infection and Barrett’s esophagus with metaplastic changes. Some literature also does report associations with HIV, Hepatitis C and gastric adenocarcinomas. Russell Bodies are made from the rough endoplasmic reticulum to form vesicles that are located within plasma cells. These are also known as Mott Cells. Symptoms usually involve epigastric pain and dysphagia that are progressive and more symptomatic. Here we present a 32 year old male with a previous food impaction presenting with persistent vomiting after eating dinner.

Case Description/Methods: A 32 year old male presented with severe dehydration from two hours of persistent vomiting after eating dinner involving a steak and onions. Patient had lab work and a physical exam indicating an acute kidney injury and hypovolemia, respectively. Patient had CT Chest with contrast showing no evidence of perforation but concern for possible stricture with evidence of a hiatal hernia. Patient was treated with intravenous fluids and glucagon with some relief. A subsequent fluid challenge was done and the patient became symptomatic with chest pain warranting endoscopic intervention. EGD showed non erosive esophagitis and gastritis. Biopsy results showed chronic inflammatory infiltrates in the lamina propria with prominent plasma cell components with many Russell Bodies without intestinal metaplasia. Patient was started on PPI therapy.

Discussion: Russell Body Esophagitis is a chronic inflammatory condition with concerns of metaplastic changes in the future. This is a condition that is associated with Barrett’s esophagus and gastric adenocarcinoma. In the setting of being an active smoker, this patient is at risk for malignancy in the future. Food impaction leading to esophagitis with chronic inflammation in a 32 year old seen in Russell Body Esophagitis is rare. Patients will need more frequent surveillance monitoring similar to those with metaplastic changes seen in patients with Barrett’s esophagus.


Disclosures:


Vijay Kata, MD, Dhaval Patel, DO, Mat Thomas, MD, Dhruv Joshi, DO. P2319 - Russell Body Esophagitis: Food Bolus Leads to Rare Diagnosis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.