Letter to the Editor

Upper Gastrointestinal Bleeding in a Patient with a History of Peptic Ulcer Disease: Don't Presume the Diagnosis

Authors: Nishant Tageja, MD, Saurabh Sethi, MD, MPH, Ankit Rathod, MD

Abstract

To the Editor:


Pemphigus vulgaris (PV) is a rare chronic autoimmune disorder characterized by the development of flaccid bullae on the skin and mucous membranes. IgG autoantibodies are produced against desmogleins (Dsg) 1 and 3, which are the desmosomal units of the skin. Symptomatic involvement of stratified squamous epithelial mucosa, especially the oral mucosa, is observed in nearly all subjects during the course of the disease and in about 48–70% of cases at onset. However, esophageal involvement is only rarely reported, frequently overlooked, and misdiagnosed as peptic ulcer disease and steroid-induced esophagitis and treated inappropriately with antacid/antisecretory medications and reduction of the daily steroid dose. We present an interesting case of PV with isolated esophageal involvement that presented with upper gastrointestinal bleeding, which, to our knowledge, has never been previously reported in the literature.

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References

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