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BMJ Case Reports 2017; doi:10.1136/bcr-2017-222405
  • Unusual association of diseases/symptoms
  • CASE REPORT

Eosinophilic oesophagitis and coeliac disease: is there an association?

  1. Horácio Guerreiro1
  1. 1Gastroenterology Department, Centro Hospitalar do Algarve, Faro, Portugal
  2. 2Histopathology Department, Centro Hospitalar do Algarve, Faro, Portugal
  1. Correspondence to Dr Ana Margarida Vaz, anam_vaz{at}hotmail.com
  • Accepted 25 October 2017
  • Published 9 November 2017

Summary

A 25-year-old man was seen in outpatient clinic for progressive solid food dysphagia. He was already medicated with a proton pump inhibitor with no improvement. His blood tests showed a slight microcytic anaemia and peripheral eosinophilia. The oesophago-gastro-duodenoscopy showed longitudinal furrows in the distal two-thirds of the oesophagus and a concentric distal stenosis. The biopsies taken showed eosinophilic infiltrates consistent with eosinophilic oesophagitis. There was no improvement with topical fluticasone, so the patient was started on a systemic corticosteroid with resolution of dysphagia and of the oesophageal stenosis. He was kept on topical steroids for symptomatic control. On repeat endoscopy, the duodenal mucosa showed multiple papules that were biopsied. Histology showed features consistent with coeliacdisease. The patient was asymptomatic but there was evidence of iron deficiency anaemia, and so a gluten-free diet was started. Despite only a partial adherence to the diet, the iron deficiency anaemia resolved.

Footnotes

  • Contributors AMV wrote the article. AJC made the histologic diagnosis. DS was involved in the direct clinical care of the patient. DS and HG reviewed the article.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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