Unique causes of esophageal inflammation: a histopathologic perspective

Abstract

Gastroenterologists frequently perform endoscopic esophageal mucosal biopsies for pathologic diagnosis in patients experiencing symptoms of esophagitis. The more common causes of esophagitis diagnosed on esophageal mucosal biopsy include reflux esophagitis, eosinophilic esophagitis, and infectious esophagitis caused by Candida albicans, herpes simplex virus, and/or cytomegalovirus. However, there are several causes of esophagitis seen less frequently by pathologists that are very important to recognize. We discuss unique types of esophageal inflammation, including acute bacterial esophagitis, esophageal manifestations of dermatologic diseases, medication-induced esophageal injury, and sloughing esophagitis; and we review their clinical and histopathologic features.

Hematemesis in pemphigus vulgaris: A challenging case of isolated esophageal flare in patient in remission

“…Mycophenolate mofetil can cause an exudative esophagitis and apoptosis, reactive epithelial changes, erosions, ulcers, and acute inflammation of the esophageal mucosa particularly when used in higher doses (2 g and above). 13 However, there was conclusive evidence for pemphigus in our case as well as the fact that she was being treated with moderate doses of MMF (≤1.5 g/day).…”

Pill-induced esophagitis caused by ingesting excessive caffeine tablets

“…Pill-induced esophagitis refers to mucosal injury caused by a lodged tablet in the esophageal lumen. A variety of drugs have been reported to induce esophagitis, and the drugs most frequently implicated are antibiotics, bisphosphonates, and non-steroidal anti-inflammatory drugs (NSAIDs) [2][3][4]6]. We have presented here an extremely rare case of pill-induced esophageal injuries caused by ingesting excessive caffeine tablets that was diagnosed and followed up via endoscopy.…”

“…Many medications have topical toxic effects on the esophageal mucosa, including the production of local hyperosmolarity (as occurs with potassium chloride), pH and osmolarity-altering effects (as seen with ferrous sulfate), and intracellular uptake and cytotoxicity (as occurs with doxycycline and NSAIDs) [6,11,12]. However, the mechanisms of mucosal injury caused by some medications, including caffeine tablets, are unclear [13].…”

Hämatemesis bei Pemphigus vulgaris: Ein herausfordernder Fall eines isolierten Ösophagusschubs bei einer Patientin in Remission

“…Mycophenolatmofetil kann eine exsudative Ösophagitis und Apoptose, eine reaktive Epithelveränderungen, Erosionen, Ulzerationen sowie akute Entzündungen der Ösophagusschleimhaut verursachen, insbesondere wenn es in höheren Dosen (2 g und mehr) verabreicht wird. 13…”