Esophagogastroduodenoscopy and Esophageal Involvement in Patients with Pemphigus Vulgaris
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Pemphigus vulgaris (PV) is a rare autoimmune blistering disease involving the skin and mucous membranes. The prevalence of esophageal involvement remains uncertain. The aim of our study was to determine the frequency of esophageal involvement in patients with PV. This is a single-center electronic database retrospective review of patients with a diagnosis of PV. Data abstracted included demographics, disease characteristics (biopsy results, symptoms, areas affected, treatments), and esophagogastroduodenoscopy (EGD) reports. Of the 111 patients that met eligibility criteria, only 22 (19.8%) underwent EGD. Demographic data were similar except those who underwent EGD were more likely to be female (77.3% vs. 51.7%, p = 0.05) and have hypertension (50.0% vs. 24.7%, p = 0.04). Esophageal symptoms were common in both groups; however, those experiencing dysphagia were more likely to undergo EGD (50.0% vs. 20.2%, p = 0.007). Those who underwent EGD had more refractory disease (≥ 3 treatment modalities: 100% vs. 58.4%, p < 0.001), but did not differ in areas affected. Of those who underwent EGD, only 4 (18.2%) had esophageal abnormalities either prior to PV diagnosis (1) or during a disease flare (3). Those having a flare were more likely to experience odynophagia (69.2%) or weight loss (61.5%), p = 0.02 and p = 0.05, respectively. While esophageal symptoms were common in our cohort of PV patients, a minority of patients underwent EGD, and the vast majority of those were unremarkable. This suggests that while esophageal symptoms are common in PV, permanent esophageal injury is more rare.
KeywordsEsophagogastroduodenoscopy Autoimmune Pemphigus vulgaris Dysphagia Esophageal symptoms Deglutition Deglutition disorders
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Conflict of interest
The authors have no conflict of interest to disclose.
- 5.Kavala M, Altintas S, Kocaturk E, Zindanci I, Can B, Ruhi C, Turkoglu Z. Ear, nose and throat involvement in patients with pemphigus vulgaris: correlation with severity, phenotype and disease activity. J Eur Acad Dermatol Venereol. 2011;25(11):1324–7. https://doi.org/10.1111/j.1468-3083.2011.03981.x.CrossRefPubMedGoogle Scholar
- 6.Kavala M, Topaloglu Demir F, Zindanci I, Can B, Turkoglu Z, Zemheri E, Cam OH, Teksen A. Genital involvement in pemphigus vulgaris (PV): correlation with clinical and cervicovaginal Pap smear findings. J Am Acad Dermatol. 2015;73(4):655–9. https://doi.org/10.1016/j.jaad.2015.06.057.CrossRefPubMedGoogle Scholar
- 12.Okamura A, Nakamura R, Yamagami J, Ishii K, Kawakubo H, Omori T, Takeuchi H, Amagai M, Kitagawa Y. Evaluation of pharyngo-oesophageal involvement in pemphigus vulgaris and its correlation with disease activity. Br J Dermatol. 2017;176(1):224–6. https://doi.org/10.1111/bjd.14725.CrossRefPubMedGoogle Scholar
- 15.Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, Johnson F, Hongo M, Richter JE, Spechler SJ, Tytgat GN, Wallin L. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45(2):172–80.CrossRefPubMedPubMedCentralGoogle Scholar