steroids and

[Guest guest]

http://highwire.stanford.edu/cgi/medline/pmid;21839711

A Case of Achalasia with Dense Eosinophilic Infiltrate Responding To Steroidal

Treatment.

E Savarino, L Gemignani, P Zentilin, N De Bortoli, A Malesci, L Mastracci, R

Fiocca, and V Savarino

Clin Gastroenterol Hepatol, August 10, 2011; .

Division of Gastroenterology, Department of Internal Medicine, University of

Genoa, Genoa, Italy.  

A patient presented with chronic substernal discomfort and

intermittent dysphagia for solids. High-resolution impedance manometry

(HRIM) of the esophagus showed that there was no peristalsis in the

esophageal body, but incomplete relaxation of the lower esophageal

sphincter and incomplete bolus transit, so the patient was diagnosed

with achalasia. Moreover, probably because of esophageal stasis,

eosinophilic infiltration that mimicked a pattern of eosinophilic

esophagitis was observed, based on multiple biopsies of the esophagus.

The patient was given 50 mg prednisolone, once daily; the symptoms

improved dramatically and HRIM showed complete recovery of esophageal

peristalsis, deeper relaxation of the lower esophageal sphincter, and

complete bolus transit profile. HRIM can therefore be used to assess

dysmotility abnormalities in patients with achalasia and

eosinophilic-like esophagitis, and steroids relieve these symptoms.

Treatment with a high dose of prednisolone resulted in a complete

disappearance of dysphagia, due to improved esophageal motility and

reduced eosinophilic infiltrate. It is therefore important to control of the

inflammatory process in patients with idiopathic achalasia, which

is likely to result from an autoimmune reaction.       

[Guest guest]

Hi Carolyn

Great article, I found you can buy for $31.5 at

http://www.sciencedirect.com/science/article/pii/S154235651100810X

I was on Prednisolone a few years back, so wondering if it may have caused the

problem? Looking through my CVS records to see what it was for, I dont remember.

CVS prescription records only cover 2 years back, so will call them.

If it would help that would be great!!

Ray CA OC 80

>

> http://highwire.stanford.edu/cgi/medline/pmid;21839711

>

> A Case of Achalasia with Dense Eosinophilic Infiltrate Responding To Steroidal

Treatment.

> E Savarino, L Gemignani, P Zentilin, N De Bortoli, A Malesci, L Mastracci, R

Fiocca, and V Savarino

> Clin Gastroenterol Hepatol, August 10, 2011; .

> Division of Gastroenterology, Department of Internal Medicine, University of

Genoa, Genoa, Italy.  

> A patient presented with chronic substernal discomfort and

> intermittent dysphagia for solids. High-resolution impedance manometry

> (HRIM) of the esophagus showed that there was no peristalsis in the

> esophageal body, but incomplete relaxation of the lower esophageal

> sphincter and incomplete bolus transit, so the patient was diagnosed

> with achalasia. Moreover, probably because of esophageal stasis,

> eosinophilic infiltration that mimicked a pattern of eosinophilic

> esophagitis was observed, based on multiple biopsies of the esophagus.

> The patient was given 50 mg prednisolone, once daily; the symptoms

> improved dramatically and HRIM showed complete recovery of esophageal

> peristalsis, deeper relaxation of the lower esophageal sphincter, and

> complete bolus transit profile. HRIM can therefore be used to assess

> dysmotility abnormalities in patients with achalasia and

> eosinophilic-like esophagitis, and steroids relieve these symptoms.

> Treatment with a high dose of prednisolone resulted in a complete

> disappearance of dysphagia, due to improved esophageal motility and

> reduced eosinophilic infiltrate. It is therefore important to control of the

inflammatory process in patients with idiopathic achalasia, which

> is likely to result from an autoimmune reaction.       

>