Eosinophilic Esophagitis in Two Patients with Systemic Sclerosis

Area of Science:

• Gastroenterology
• Rheumatology
• Pulmonology

Background:

• The gastrointestinal tract (GIT) is frequently affected in systemic sclerosis (SSc), with the esophagus being the most commonly involved organ.
• Gastroesophageal reflux (GER) is associated with SSc and interstitial lung disease (ILD), necessitating aggressive GER management in affected patients.
• Understanding the long-term benefits of GER treatment in SSc-ILD requires further investigation.

Purpose of the Study:

• This case report highlights the presence of eosinophilic esophagitis (EoE) in two patients with SSc.
• It discusses the utility of early esophagogastroduodenoscopy (EGD) for tissue analysis in SSc patients experiencing moderate to severe GER symptoms.
• The study aims to explore the role of EoE in SSc pathogenesis and its implications for patient management.

Main Methods:

• Case report detailing two patients with systemic sclerosis (SSc) and eosinophilic esophagitis (EoE).
• Review of clinical presentation, GER symptoms, and diagnostic findings, including EGD and esophageal biopsies.
• Analysis of biopsy specimens for eosinophil infiltration and potentially antinuclear antibodies (ANA).

Main Results:

• Two cases of SSc with co-existing eosinophilic esophagitis (EoE) were identified.
• Esophageal biopsy findings in SSc patients with GER symptoms can reveal eosinophilic infiltration.
• The presence of EoE in SSc has significant implications for treatment strategies, including dietary modifications.

Conclusions:

• Eosinophilic esophagitis (EoE) should be considered in systemic sclerosis (SSc) patients presenting with moderate to severe gastroesophageal reflux (GER) symptoms.
• Early esophagogastroduodenoscopy (EGD) with esophageal biopsies is valuable for diagnosing EoE in this population.
• Identifying EoE in SSc patients is crucial for optimizing management, particularly regarding dietary interventions and understanding disease interplay.