Judy Sheffeh, MD1, Mohammad Ali Sheffeh, MD2, Katie Claxton, MS1, Mohammed Barawi, MD3 1Ascension Macomb-Oakland Hospital, Warren, MI; 2Ascension Macomb, Warren, MI; 3Ascension St. John Hospital, Detroit, MI
Introduction: Dysphagia can arise from a variety of causes. The clinical presentation and patient demographics help guide differential diagnosis. Lymphocytic esophagitis (LyE) is a rare esophageal condition that presents as dysphagia. Here, we present a case of LyE in an adult woman with Crohn’s disease (CD).
Case Description/Methods: A 43-year-old female with Crohn's disease, a history of ileosigmoid fistula treated with ileocolic resection, and currently in remission on Certolizumab, presented with worsening dysphagia primarily to solid foods over the past year. She also has chronic GERD managed with Omeprazole. Esophagogastroduodenoscopy (EGD) revealed esophageal mucosal changes suggestive of eosinophilic esophagitis and a mild Schatzki ring, which was dilated during the procedure. Pathological examination showed increased intraepithelial lymphocytes ( >20 per high-power field) in the distal and mid esophagus without increased intraepithelial eosinophils. The patient was diagnosed with lymphocytic esophagitis (LyE) and advised to continue Omeprazole. She was instructed to return for endoscopic dilation if symptoms recurred.
Discussion: Lymphocytic esophagitis (LyE) is a rare esophageal disease with reported risk factors including achalasia, older age, female sex, smoking, and hiatal hernia. Recent systematic reviews have indicated that approximately 4.3% of adults with LyE also have Crohn's disease (CD), whereas the prevalence is higher at 19.4% among pediatric patients. However, two studies have found no significant association between LyE and CD in adults. Therefore, the relationship between LyE and CD in adult patients remains unclear, with limited literature available. Reporting more similar cases will help in conducting more studies to assess the association in adults and direct further screening and management.
Disclosures:
Judy Sheffeh indicated no relevant financial relationships.
Mohammad Ali Sheffeh indicated no relevant financial relationships.
Katie Claxton indicated no relevant financial relationships.
Mohammed Barawi: Abbvie – Speakers Bureau. Boston scietific – Consultant. Gilead – Speakers Bureau. Olympus – Consultant.
Judy Sheffeh, MD1, Mohammad Ali Sheffeh, MD2, Katie Claxton, MS1, Mohammed Barawi, MD3. P2315 - Lymphocytic Esophagitis and Crohn's Disease in Adult, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
