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Refractory hemorrhagic esophageal ulcers by Candida esophagitis with advanced systemic sclerosis

A 64‐year‐old woman diagnosed with rheumatoid arthritis (RA) and systemic sclerosis (SSc) was admitted to our hospital with chief complaints of uncontrolled bleeding from esophageal ulcers and an inability to consume meals. For RA and SSc, she was treated with prednisolone and abatacept and was taki...

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Detalles Bibliográficos
Autores principales: Natsui, Kazuki, Tsuchiya, Atsunori, Terai, Shuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578314/
https://www.ncbi.nlm.nih.gov/pubmed/33102777
http://dx.doi.org/10.1002/jgh3.12353
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author Natsui, Kazuki
Tsuchiya, Atsunori
Terai, Shuji
author_facet Natsui, Kazuki
Tsuchiya, Atsunori
Terai, Shuji
author_sort Natsui, Kazuki
collection PubMed
description A 64‐year‐old woman diagnosed with rheumatoid arthritis (RA) and systemic sclerosis (SSc) was admitted to our hospital with chief complaints of uncontrolled bleeding from esophageal ulcers and an inability to consume meals. For RA and SSc, she was treated with prednisolone and abatacept and was taking vonoprazan as prophylaxis for steroid‐induced gastric ulcers. She was diagnosed with severe Candida esophagitis, with multiple large and small ulcers with bleeding, based on esophagogastroduodenoscopy and pathological findings. We performed comprehensive treatment; abatacept was discontinued, and total parenteral nutrition was initiated along with antifungal therapy. Improvement in the esophageal ulcers was observed. Although severe Candida esophagitis is a rare condition, we should keep in mind that severe Candida esophagitis can occur in patients with an immunosuppressive compromised host and esophageal movement disorders such as SSc. Regular follow up by endoscopy and prophylactic treatment to prevent severe esophagitis may be necessary.
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spelling pubmed-75783142020-10-23 Refractory hemorrhagic esophageal ulcers by Candida esophagitis with advanced systemic sclerosis Natsui, Kazuki Tsuchiya, Atsunori Terai, Shuji JGH Open Case Reports A 64‐year‐old woman diagnosed with rheumatoid arthritis (RA) and systemic sclerosis (SSc) was admitted to our hospital with chief complaints of uncontrolled bleeding from esophageal ulcers and an inability to consume meals. For RA and SSc, she was treated with prednisolone and abatacept and was taking vonoprazan as prophylaxis for steroid‐induced gastric ulcers. She was diagnosed with severe Candida esophagitis, with multiple large and small ulcers with bleeding, based on esophagogastroduodenoscopy and pathological findings. We performed comprehensive treatment; abatacept was discontinued, and total parenteral nutrition was initiated along with antifungal therapy. Improvement in the esophageal ulcers was observed. Although severe Candida esophagitis is a rare condition, we should keep in mind that severe Candida esophagitis can occur in patients with an immunosuppressive compromised host and esophageal movement disorders such as SSc. Regular follow up by endoscopy and prophylactic treatment to prevent severe esophagitis may be necessary. Wiley Publishing Asia Pty Ltd 2020-05-12 /pmc/articles/PMC7578314/ /pubmed/33102777 http://dx.doi.org/10.1002/jgh3.12353 Text en © 2020 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Natsui, Kazuki
Tsuchiya, Atsunori
Terai, Shuji
Refractory hemorrhagic esophageal ulcers by Candida esophagitis with advanced systemic sclerosis
title Refractory hemorrhagic esophageal ulcers by Candida esophagitis with advanced systemic sclerosis
title_full Refractory hemorrhagic esophageal ulcers by Candida esophagitis with advanced systemic sclerosis
title_fullStr Refractory hemorrhagic esophageal ulcers by Candida esophagitis with advanced systemic sclerosis
title_full_unstemmed Refractory hemorrhagic esophageal ulcers by Candida esophagitis with advanced systemic sclerosis
title_short Refractory hemorrhagic esophageal ulcers by Candida esophagitis with advanced systemic sclerosis
title_sort refractory hemorrhagic esophageal ulcers by candida esophagitis with advanced systemic sclerosis
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578314/
https://www.ncbi.nlm.nih.gov/pubmed/33102777
http://dx.doi.org/10.1002/jgh3.12353
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