Pemphigus Vulgaris with Marked Stenosis of the Esophageal Orifice from an Osteoporosis Drug: a Case Study with Long-term Follow-up

Ishibashi Takuya

Hirakawa Katsuhiro

Takeno Sachio

Takumida Masaya

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

Pemphigus vulgaris produces multiple and intractable erosions of the oral mucosa in the head and neck region. We describe a case of pemphigus vulgaris that showed erosions in the hypopharynx and stenosis of the esophageal orifice from an osteoporosis drug. A 73-year-old woman was admitted with oral intake difficulty and erosions in the hypopharynx. During the first admission, we could not make a definite diagnosis by biopsy or blood examination. The condition of the mucosa worsened subsequently; an esophagram showed marked stenosis of the esophageal orifice. As a possible factor exacerbating the stenosis, an osteoporosis drug was considered. The stenosis was improved by balloon expansion. One year after the first medical examination, we finally made a definite diagnosis of pemphigus vulgaris from the results of a blood examination in which anti-desmoglein 3 turned positive when the hypopharyngeal erosions and stenosis of the esophageal orifice became worse. Systemic treatment with a steroid was effective for the control of pemphigus vulgaris; restenosis of the esophageal orifice was recognized twice during a state of remission, and careful follow-up will be necessary in the future.

Pemphigus Vulgaris

Stenosis of esophageal orifice

Osteoporosis drug

Medical sciences [ 490 ]

eng

Hiroshima University Medical Press

Copyright (c) 2017 Hiroshima University Medical Press

[ISSN] 0018-2052

[ISSN] 2433-7668

[NCID] AA00664312

[DOI] 10.24811/hjms.66.2_27

[DOI] https://doi.org/10.24811/hjms.66.2_27