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Case Reports in Rheumatology
Volume 2016, Article ID 6410421, 5 pages
http://dx.doi.org/10.1155/2016/6410421
Case Report

Eosinophilic Esophagitis in Two Patients with Systemic Sclerosis

1Division of Rheumatology, Department of Internal Medicine, University of Utah School of Medicine, 4B200 30 N. 1900 E., Salt Lake City, UT 84132, USA
2Division of Gastroenterology, Department of Internal Medicine, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA
3Department of Anatomic Pathology, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA
4Department of Ophthalmology, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA
5Division of Infectious Diseases, Department of Internal Medicine, University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA

Received 3 November 2015; Accepted 31 December 2015

Academic Editor: James V. Dunne

Copyright © 2016 Tracy M. Frech et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The gastrointestinal tract (GIT) is the most common extracutaneous organ system damaged in systemic sclerosis (SSc) and is the presenting feature in 10% of patients. The esophagus as the portion of the GIT is the most commonly affected and there is an association of gastroesophageal reflux (GER) with SSc interstitial lung disease (ILD). Thus, an aggressive treatment for GER is recommended in all SSc patients with ILD; however, it is recognized that a long-term benefit to this treatment is needed to understand its impact. In this case report we discuss the presence of eosinophilic esophagitis (EoE) in two SSc patients and discuss the role for early EGD in SSc patients with moderate-severe GER symptoms for tissue study. Assessment of esophageal biopsy specimens for the presence of eosinophils and possibly ANA can help elucidate disease pathogenesis and direct therapy, as the presence of EoE in SSc has important management considerations, particularly with regards to dietary modification strategies.