3.8 Article

A case of eosinophilic esophagitis with autoimmune polyendocrine syndrome type 2, including autoimmune gastritis

Journal

CLINICAL JOURNAL OF GASTROENTEROLOGY
Volume 14, Issue 2, Pages 460-465

Publisher

SPRINGER JAPAN KK
DOI: 10.1007/s12328-020-01333-y

Keywords

Eosinophilic esophagitis; Autoimmune gastritis; Autoimmune polyendocrine syndrome; Regulatory T cells

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This case highlights a rare occurrence of coexisting eosinophilic esophagitis and autoimmune polyendocrine syndrome in a 67-year-old Japanese man. Treatment with proton-pump inhibitor was ineffective, but symptoms improved with topical steroid therapy. The case has implications for understanding the pathogenesis of both conditions.
Both eosinophilic esophagitis (EoE) and autoimmune polyendocrine syndrome (APS) are relatively rare diseases in Japan. We herein report a case of EoE with APS in a 67-year-old Japanese man who presented with chest pain and dysphagia. On the basis of endoscopic findings and histological analysis, we diagnosed the patient with EoE along with autoimmune gastritis. Additional serological examinations revealed the presence of Hashimoto's thyroiditis and type 1 diabetes, which led to the final diagnosis of APS. His symptoms did not respond to treatment with a proton-pump inhibitor but improved with topical steroid therapy. This case of coexisting EoE and APS-2 is quite rare and has several implications for the pathogenesis of both conditions.

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