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An 81-year-old white man presented with 2 weeks of odynophagia and dysphagia to solids and liquids limiting his oral intake and leading to 5 lb weight loss. He has a history of chronic myelomonocytic leukaemia with recent transition to myelofibrosis, uncontrolled gastro-oesophageal reflux disease (GORD) and chronic obstructive pulmonary disease on home oxygen. He denied fever, chills, nausea, vomiting, early satiety, abdominal pain, melena or haematemesis. The physical examination was unremarkable, and he had no oral thrush. His laboratory tests showed pancytopenia (absolute neutrophils count 62 cells/mm3, haemoglobin 80 g/L, platelets 17 000 cells/mm3). A CT chest showed diffuse oesophageal wall thickening and normal stomach. Oesophagogastroduodenoscopy demonstrated erosive oesophagitis with several distal oesophageal ulcers. Biopsies were negative for viral particles and confirmed reflux disease. There were numerous non-bleeding, …
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Contributors Project design/conception: FB and JMK. Data and figures chart extraction: FB. Manuscript drafting: FB and SA. Provide pathology slide images and interpretation: ML. Critical revision of the manuscript: ME-M, AB and JMK. All authors were involved in care of the patient and approved the final draft submitted.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.