A Rare Case of Eosinophilic Esophagitis Accompanied by Oropharyngeal Dysphagia and Aspiration
- Author:
Jisun BAE
1
;
Soohoan LEE
;
Jisoo PARK
;
Hae-Yeon PARK
;
Sun IM
Author Information
- Publication Type:Case Report
- From: Journal of the Korean Dysphagia Society 2024;14(Supple):155-160
- CountryRepublic of Korea
- Language:English
- Abstract: A 74-year-old woman presented with a progressive pattern of dysphagia and odynophagia over one month.Magnetic resonance imaging of the neck revealed diffuse swelling from the tongue base and velum extending to the posterior pharyngeal wall. Instrumental evaluation of swallowing showed decreased peristalsis in the esophageal phase, accompanied by severe swelling of the hypopharynx, which limited laryngeal elevation and subsequently led to decreased bolus clearance and impaired airway protection. Laboratory studies revealed a 61% increase in eosinophil count. An endoscopic biopsy of the esophagus confirmed the diagnosis of eosinophilic esophagitis. The patient was administered intravenous dexamethasone at a total dosage of 45 mg/day for 7 days. The eosinophil count dropped to the normal range, correlating with the improvement in dysphagia and aspiration. Eosinophilic esophagitis often presents in children and rarely involves the oropharyngeal structures. Due to its specific involvement of the esophagus, it seldom leads to aspiration. By contrast, the extension of eosinophilic inflammation from the esophagus to the oropharynx in this case resulted in atypical symptoms such as odynophagia and aspiration. The therapeutic approach can be challenging due to the difficulty in administering topical steroids, which are often the treatment of choice. However, the condition showed an excellent response to intravenous steroid therapy.
