S3258 A Rare Case of Eosinophilic Esophagitis Presenting as Multiple Esophageal Polyps

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Introduction: Eosinophilic esophagitis is an autoimmune inflammatory disease of the esophagus. The hallmark symptoms of this disease frequently involve acid reflux and dysphagia. Typical endoscopic findings of eosinophilic esophagitis show circular rings, linear furrows, whitish papules, and plaques. Eosinophilic esophagitis is rarely associated with esophageal polyps, and very few cases of this association have been reported in the literature. Thus, medical providers are faced with challenges when encountering this unique endoscopic finding. Case Description/Methods: In this case presentation, we present a 47-year-old man with no significant past medical history who initially presented with dysphagia for 7 months. Given the significant distress the patient was experiencing from his dysphagia, he underwent an endoscopy and was found to have multiple diminutive esophageal polyps. Biopsies were obtained which revealed 100 eosinophils per high power field. Interestingly, the patient had no reported history of asthma, eczema, or food allergies. This patient’s overall clinical picture paired with these endoscopic findings serve as an atypical case of eosinophilic esophagitis. Discussion: The rates of eosinophilic esophagitis are increasing in the United States and worldwide. This condition is chronic and affects about 56.3 per 100,000 patients per year. There is no definite cure for eosinophilic esophagitis. Long term complications may arise such as fibrosis of the esophagus due to repeated bouts of inflammation. Thus, treatment with proton pump inhibitors is paramount. After careful review of the literature, there have been very few cases of adults presenting with this association. Although this remains an extremely rare finding, the association between esophageal esophagitis and esophageal polyps should not be overlooked as a possible cause for a patient’s dysphagia (see Figure 1).Figure 1.: Esophagus containing multiple diminutive polyps.

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