Article Text

PDF
Paper
Case report: Achalasia-like dysmotility secondary to oesophageal involvement of sarcoidosis
  1. Albert J Bredenoord1,
  2. Jafar Jafari2,
  3. Saleheen Kadri1,
  4. David E Simcock3,
  5. Daniel Sifrim2,
  6. Sean L Preston1
  1. 1Department of Gastroenterology, Barts and The London NHS Trust, London, UK
  2. 2Upper Gastrointestinal Physiology Unit, Barts and the London School of Medicine and Dentistry, London, UK
  3. 3Department of Respiratory Medicine, Barts and The London NHS Trust, London, UK
  1. Correspondence to Dr Sean L Preston, Department of Gastroenterology, Endoscopy Unit, The Royal London Hospital, Whitechapel, London E1 1BB, UK; sean.preston{at}bartsandthelondon.nhs.uk

Abstract

We present a case of a patient with sarcoidosis and who subsequently developed dysphagia for solids, and some difficulty in swallowing liquids. High-resolution manometry of the oesophagus showed absent peristalsis in the oesophageal body and incomplete relaxation of the lower oesophageal sphincter. The diagnosis of sarcoidosis with oesophageal involvement was made and treatment with prednisolone 30 mg OD initiated. The patient improved symptomatically and high-resolution manometry was repeated showing complete recovery of oesophageal peristalsis and a deeper relaxation of the lower oesophageal sphincter. This is thus the first description of high-resolution manometry in sarcoidosis-induced changes of the oesophagus and of the effect treatment has on these motility changes. Oesophageal involvement of sarcoidosis is extremely rare and only a few cases have been reported. The symptoms and manometric pattern of this disorder mimics that of achalasia. However, we show that treatment with prednisolone results in a completely disappearance of the symptoms of dysphagia and subsequently lead to a large improvement of oesophageal motility.

  • Sarcoidosis
  • oesophageal
  • motility
  • achalasia
  • manometry
  • motility disorders
  • oesophageal motility
View Full Text

Statistics from Altmetric.com

Footnotes

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.