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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Feeding refusal is often described in conjunction with the diagnosis of eosinophilic esophagitis (EE) in pediatric patients; however, there are little data regarding the specific clinical manifestations and effective management of this condition in very young children. The aim of this study was to evaluate the presentation of EE in infants and toddlers referred to the Interdisciplinary Feeding Team Clinic of a tertiary referral center and to document responses to treatment. Database matching was performed (from January 2000 to June 2003) to identify infants and toddlers diagnosed with EE who had been referred to the Interdisciplinary Feeding Team Clinic. Endoscopic features required for a diagnosis of EE included esophageal mucosal furrowing, erythema, exudates, or decreased vascular markings. Histologic features of EE were more than 24 eosinophils per high-power field (HPF), thickening of basal cell layer, and papillary (rete peg) lengthening or elongation. All study patients were treated with a combination of proton pump inhibitors (PPI) and fluticasone (swallowed). In addition, elemental diet was instituted in those documented to have a food allergy. Treatment success was defined by an improved oral intake, adequate weight gain, and improved endoscopic and histologic findings at 3-6-month followup. A total of 15 subjects [mean age = 19.9 months (SD = 9.7 months)] who fulfilled the entry criteria during the study period were identified. All 15 children had documented endoscopic improvement and 14/15 children had histologic resolution of EE after therapy. In 13 of the 15 children, this translated to clinical improvement as well.
Dysphagia 2007 Jan
PMID:Eosinophilic esophagitis in infants and toddlers. 1702 45

A man with no atopic antecedent, but who was being treated with a Angiotensin-converting enzyme inhibitor (ACE), was admitted to hospital for an edema affecting the face and tongue. The symptoms included dyspnea and dysphagia but not pruritus or dermal erythema. The patient was resistant to corticoid treatment, antihistaminic drugs and epinephrine. Treatment with C1 inhibitor concentrate (1000u) made the clinical symptoms disappear within 20 minutes. The resulting angioedema induced seems to be linked to the bradykinin metabolism, which would not be any better served by the angiotensin-converting enzyme, which normally inactivates about 75% of it.
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PMID:[Angiotensin-converting enzyme inhibitor-related angioedema: emergency treatment with complement C1 inhibitor concentrate]. 1809 74

A 31-year-old woman with a history of bilateral carpal tunnel surgery complained of worsening hand pains and swelling. Subsequently, she presented for rheumatologic evaluation with generalized arthralgias, symmetric polyarthritis of the hands and feet, shiny skin with tightness and thickening, tender periungual erythema, malar rash, and photosensitivity. The only laboratory abnormality found then was a positive antinuclear antibody. Her joint symptoms were responsive to low-dose prednisone and hydroxychloroquine. However, the skin tightness progressed proximally and centrally and developed around the mouth. At that point, more specific autoimmune work-up showed negative relevant antibodies, and repeat antinuclear antibody tests turned out negative. Later, she reported dysphagia and hoarseness, and ecchymotic rashes appeared on the face and forearm. Biopsy of the forearm lesion showed leukocytoclastic vasculitis. Staining for amyloid was negative. Subsequently, she was found to have hypogammaglobulinemia and Bence-Jones proteinuria; the progression of her skin symptoms provoked a repeat skin biopsy with special stains that demonstrated amyloidosis. Bone marrow biopsy showed >75% plasma cells, skeletal survey revealed multiple lytic lesions, and a diagnosis of multiple myeloma with associated amyloidosis was made. Despite the initial features of connective tissue disease in this young woman, a steadfast workup revealed the source of her problem.
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PMID:Scleroderma-like illness as a presenting feature of multiple myeloma and amyloidosis. 1852 36

Sarcoidosis is a common disease and affects the respiratory system in > 90% of cases, most commonly the intrathoracic lymph nodes and the respiratory parenchyma. Less commonly, the airways are involved, and the disease is manifested as mucosal erythema, edema, granularity and cobblestoning, plaques, nodules, and bronchial stenosis, airway distortion, traction bronchiectasis, and bronchiolitis. Airway involvement may lead to airflow limitation. Involvement of oral, nasal, and pharyngeal mucosa may cause hoarseness, dysphagia, laryngeal paralysis, and upper airway obstruction. Airway symptoms are important indicators of airway involvement in sarcoidosis. Pulmonary function testing, radiologic imaging, and bronchoscopy occupy a significant role in the diagnosis and management of airway involvement in patients with sarcoidosis.
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PMID:Airway involvement in sarcoidosis. 1989 76

Laryngopharyngeal reflux (LPR), an extraesophageal variant of gastroesophageal reflux disease, is associated with hoarseness, chronic cough, throat-clearing, sore throat, and dysphagia. But because these symptoms are nonspecific, laryngoscopy is often done and the diagnosis of LPR is considered if edema, erythema, ventricular obliteration, pseudosulcus, or postcricoid hyperplasia is noted. Most patients with suspected LPR are given a 2-month trial of a proton pump inhibitor. Yet there is still little or no solid evidence on which to base the diagnosis or the treatment of LPR. We review the current understanding of the pathophysiology and discuss current diagnostic tests and treatment regimens in patients with suspected LPR.
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PMID:Laryngopharyngeal reflux: More questions than answers. 2043 65

A 30-year-old woman who was 2 weeks postpartum presented with intermittent dysphagia since delivery. Esophagogastroduodenoscopy (EGD) revealed linear furrowing, trachealization, and a B-type distal esophageal ring with normal appearing stomach and duodenum. Biopsies showed eosinophilic esophagitis. Over 3 weeks, she developed severe midepigastric pain. Laboratory studies revealed an elevated absolute eosinophil count of 990/dL (normal 0-450/dL), and a computed tomography scan showed proximal jejunal thickening. Repeat esophagogastroduodenoscopy showed gastric erythema and edema of the duodenal mucosa. Biopsies revealed greater than 50 eosinophils per high power field in the intraepithelial mucosa with extension into the muscularis and serosa, consistent with eosinophilic gastroenteritis (EG). EG represents an uncommon inflammatory disease marked by gastrointestinal symptoms, eosinophilic infiltration in one or more areas of the gastrointestinal tract, and absence of parasitic or extraintestinal disease. Approximately 300 cases have been reported since 1937. This case contains two unique aspects. First, the clinical and endoscopic progression of gastrointestinal eosinophilic disease from the esophagus to the stomach and small bowel was chronologically documented. This proximal to distal luminal progression has not been previously reported. The possible link to her pregnancy is also notable as only two previous cases of labor-associated EG have been published.
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PMID:Labor-associated eosinophilic gastroenteritis. 2233 89

Gastroesophageal reflux disease (GERD) is a disease that has come to limelight in the rreent past to account for various ear, nose and throat disorders. Fifty patients from my outpatient department, presenting with chronic dry paroxysmal cough, choking spells, globus sensation, voice change, burning throat syndrome, dysphagia were evaluated, with both invasive and non-invasive techniques like Fibreoptic Nasoendoscopy, Nuclear Scintigraphy with technetium, Barium swallow, sans pH monitoring which is an expensive and laborious method.We have shown evidence of GER with help of Nasoendoscopy, which revealed posterior laryngitis, erythema of arytenoids and interarytenoid oedema. This is corroborated with Scintigraphy done in Nuclear Medicine department, which is our gold standard for labelling the cases as GERD. Basing on the investigations, we have treated successfully fifty cases with medical treatment consisting of H2 Hockers, proton pump inhibitors and microlaryngeal surgery wherever necessary. In this article we are discussing the various symptoms, the fifty patients complained of, and how we are able to pinpoint the diagnosis and the modality we adopted with the facilities available, and also a brief review of literature.
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PMID:Supraoesophageal manifestations of gerd- A myth or reality? 2311 87

The association of erythroderma and dermatomyositis is rare. In 6 reported cases found by searching Pubmed, half of them were associated with digestive tract neoplasms (stomach and liver). We report the case of a 69 years-old woman with bilateral proximal weakness, joint pain, photosensitivity, facial and heliotrope erythema lasting 18 months. One month prior to hospital admission she showed progressive dysphagia and a universal erythema and scaling that affected mucosa, palms and soles with an accompanying weight loss of 10 kg in 6 months. No malignancy was identified at any level despite an exhaustive search.
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PMID:Dermatomyositis-erythrodermia: clinical presentation not associated to malignancy. A case report. 2354 45

A healthy 10-year-old boy presented with fever and progressively worsening sore throat and dysphagia. Physical examination showed pharyngeal erythema with tender left cervical lymphadenopathy. Radiography revealed 9 mm deep prevertebral soft tissues at the C2 level, and contrast-enhanced CT showed fluid collection with no major ring enhancement in the retropharyngeal space. He was diagnosed with retropharyngeal cellulitis and treated with intravenous antibiotics. Retropharyngeal cellulitis or abscess is a relatively rare infection in adolescents but is more frequent in 2-4-year-old children. Retropharyngeal cellulitis may rapidly extend caudally, with fatal consequences. For adolescents, physicians need to be aware of this clinical entity and carefully evaluate imaging findings even when only the mild pharyngeal physical findings are noted.
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PMID:Retropharyngeal cellulitis in adolescence. 2368 69

Scalp angiosarcoma represents a therapeutic challenge to all disciplines. This case report demonstrates the potential usefulness of helical tomotherapy (HT) as a new radiotherapeutic treatment option. A 71-year-old woman presented with a superficial angiosarcoma of the scalp, forehead, and left pre- and postauricular areas, with several nodular ulcerating and bleeding lesions. Irradiation of the gross tumor was performed with a total dose of 70 Gy in 2-Gy fractions and of the left cervical lymph nodes with 56 Gy in 1.6-Gy fractions. Good target coverage was achieved without compromising organs at risk, notably the brain. Treatment was very fast (661 seconds per fraction) and was administered with minimal acute toxicity (National Cancer Institute Common Toxicity Criteria: grade 2 erythema and grade 2 dysphagia). During treatment, tumor nodules dissolved into hyperkeratosis. We conclude that with HT, irradiation of the scalp and cervical lymph nodes can be conducted with minimal acute toxicity and without junction problems.
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PMID:Helical tomotherapy of the complete scalp and the ipsilateral lymph nodes in a case of scalp angiosarcoma. 2493 25


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