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A 52-year-old man with heartburn and weight loss
  1. Giuseppe Gizzi1,
  2. Maria Pia Foschini2,
  3. Carlo Fabbri3,
  4. Lorenzo Fuccio4
  1. 1Endoscopy Unit, M.F. Toniolo Hospital, Bologna, Italy
  2. 2Department of Biomedical and Neuromotor Sciences, University of Bologna, Anatomic Pathology at Bellaria Hospital, Bologna, Italy
  3. 3Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
  4. 4Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
  1. Correspondence to Dr Lorenzo Fuccio, Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, V. Massarenti 9, Bologna 40138, Italy; lorenzofuccio{at}

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A previously fit and well 52-year-old man presented to the hospital with a 3-month history of refractory heartburn and progressive weight loss (5 kg). After an initial response to empiric treatment with 20 mg omeprazole daily, heartburn relapsed and became refractory to proton pump inhibitor. His past medical history and physical examination were unremarkable. Upper endoscopy showed a thick white membrane in the distal part of the oesophagus, crossing the gastro-oesophageal junction (figure 1A); the mucosa surrounding the distal margin was slightly depressed but not reddened. An initial diagnosis of candidosis was suggested and …

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