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Idiopathic giant oesophageal ulcer in an immunocompetent patient. The efficacy of thalidomide treatment
  1. S OLLIVIER,
  2. J BONNET,
  3. M LEMANN,
  4. J-C COFFIN,
  5. R MODIGLIANI,
  6. R JIAN
  1. P BERTHEAU
  1. J-F FLEJOU
  1. Department of Gastroenterology
  2. Department of Pathology
  3. Hôpital Saint-Louis
  4. 75475 Paris CEDEX 10
  5. France
  6. Department of Pathology
  7. Hôpital Beaujon
  8. Paris
  9. France
  1. Dr Jian.

https://doi.org/10.1136/gut.45.3.463

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    Background

    Idiopathic oesophageal ulcers have only been described in patients with acquired immunodeficiency syndrome (AIDS). We report the first case occurring in an immunocompetent patient.

    Case history

    A 52 year old man presented with a one year history of odynophagia, retrosternal chest pain, dysphagia, and a 10 kg weight loss. He had no history of gastrointestinal disease and had not taken drugs. An upper endoscopy, performed shortly after symptom onset, showed a 3 cm solitary oesophageal ulcer with smooth and irregular margins 3 cm above the gastro–oesophageal junction. Biopsy samples showed acute and chronic inflammation without any fungal or viral particles. Despite three months on a proton pump inhibitor, symptoms and endoscopic findings did not change. Oesophageal manometry and pH metry were normal, and endoscopic …

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