scholarly journals Pemphigus Vulgaris in the Mouth and Esophageal Mucosa

2018 ◽  
Vol 12 (2) ◽  
pp. 260-265 ◽  
Author(s):  
Angelo Gualberto de Macedo ◽  
Erika Ruback Bertges ◽  
Luiz Carlos Bertges ◽  
Renata Alvim Mendes ◽  
Thais Abranches Bueno Sabino Bertges ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Medical Care ◽  
Pemphigus Vulgaris ◽  
Esophageal Mucosa ◽  
Digestive Endoscopy ◽  
Initial Manifestation ◽  
Esophageal Involvement ◽  
Mucous Membranes ◽  
Upper Digestive Endoscopy

Pemphigus vulgaris (PV) is a chronic autoimmune mucocutaneous disease. In most cases, the initial manifestation occurs in the mouth as multiple ulcerations preceded by blisters that rupture and later spread to other mucous membranes and the skin. Esophageal impairment is rare. We report a case of PV with esophageal involvement in a 53-year-old woman who sought medical care, complaining of diffuse painful lesions in the oral cavity for approximately 1 month, with no improvement with nystatin. Upper digestive endoscopy (UDE) was performed with findings of vesiculobullous lesions in the proximal and middle esophagus, which were biopsied and for which histopathology confirmed PV in the esophageal mucosa. We draw attention to UDE as important for the diagnosis, and it should be indicated in patients with vesiculobullous lesions of the mouth, especially if there are esophageal complaints.

scholarly journals Nasal, Oral, and Pharyngolaryngeal Manifestations of Pemphigus Vulgaris: Endoscopic Ororhinolaryngologic Examination

2017 ◽  
Vol 96 (3) ◽  
pp. 120-127 ◽  
Author(s):  
Masafumi Ohki ◽  
Shigeru Kikuchi
Keyword(s):  
Oral Cavity ◽  
Soft Palate ◽  
Buccal Mucosa ◽  
Nasal Septum ◽  
Vocal Fold ◽  
Pemphigus Vulgaris ◽  
Gingival Bleeding ◽  
Oral Pain ◽  
Mucous Membranes ◽  
Clinical Records

Pemphigus vulgaris is an autoimmune blistering disorder that involves the skin and mucous membranes. Few reports have described nasal and oropharyngolaryngeal lesions in pemphigus vulgaris using an endoscopic ororhinolaryngologic examination. We retrospectively reviewed the clinical records of 11 patients with pemphigus vulgaris between 2001 and 2013 with respect to their symptoms, lesion sites, lesion features, and treatments received. All patients had undergone an endoscopic ororhinolaryngologic examination. Their mucosa-related symptoms were sore throat, oral pain, odynophagia, gingival bleeding, hoarseness, and epistaxis. The most frequent sites were the oral cavity (gingiva and buccal mucosa), larynx (epiglottis and vocal fold), oropharynx (soft palate), and nasal cavity (nasal septum). Lesions were typically characterized by erosion, erosion with a whitish exudate, and erythematous patches. Thus, our study findings reveal that pemphigus vulgaris involves both the nasal and oropharyngolaryngeal regions. Patients with pemphigus vulgaris should undergo an endoscopic ororhinolaryngologic examination to determine the range of their lesions.

scholarly journals GASTROESOPHAGEAL REFLUX DISEASE: A PRACTICAL APPROACH

2021 ◽  
Vol 58 (4) ◽  
pp. 525-533
Author(s):  
Gerson DOMINGUES ◽  
Joaquim Prado P de MORAES-FILHO
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Situation ◽  
Clinical Findings ◽  
Clinical Treatment ◽  
Esophageal Mucosa ◽  
Digestive Endoscopy ◽  
Precise Diagnosis ◽  
Upper Digestive Endoscopy

ABSTRACT Gastroesophageal reflux disease (GERD) presents typical manifestations such as heartburn and/or regurgitation as well as atypical manifestations such as throat symptoms, laryngitis, hoarseness, chronic cough, asthma, and sleep alterations. There are two phenotypes of the disease: erosive GERD, when erosions are identified by upper digestive endoscopy, and non-erosive GERD, when the esophageal mucosa presents a normal endoscopic aspect. Relevant clinical findings are usually absent in the physical examination, but it should be highlighted that obesity is an important aggravating factor of reflux. The treatment is established based on clinical findings and, according to the clinical situation, on complementary exams such as upper digestive endoscopy. In dubious cases where a precise diagnosis is required, the indicated test is esophageal pHmetry or impedance-pHmetry. Clinical treatment is divided into behavioral/dietary measures and pharmacological measures. Most patients benefit from clinical treatment, but surgical treatment may be indicated in the presence of a larger hiatal hernia and complications of the disease.

scholarly journals CORRELATION BETWEEN PRE AND POSTOPERATIVE UPPER DIGESTIVE ENDOSCOPY IN PATIENTS WHO UNDERWENT ROUX-EN-Y GASTROJEJUNAL BYPASS

2016 ◽  
Vol 29 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Leticia Elizabeth Augustin CZECZKO ◽  
Manoela Aguiar CRUZ ◽  
Flávia Caroline KLOSTERMANN ◽  
Nicolau Gregori CZECZKO ◽  
Paulo Afonso Nunes NASSIF ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Hiatus Hernia ◽  
Statistical Significance ◽  
Erosive Esophagitis ◽  
Marginal Ulcer ◽  
Esophageal Mucosa ◽  
Upper Endoscopy ◽  
Digestive Endoscopy ◽  
Erosive Gastritis ◽  
Upper Digestive Endoscopy

Background : Bariatric operations have variable range of complications and postoperative benefits. Gastroesophageal reflux is considered potential factor that may result in damage to the esophageal mucosa and this subject is quite controversial in the literature. Aim: To evaluate patients who underwent to Roux-en-Y gastrojejunal bypass correlating epidemiologic and endoscopic findings in pre and postoperative periods. Method: A retrospective, paired study which evaluated 110 patients. Inclusion criteria were formal indication for bariatric surgery and patients with pre and postoperative endoscopy. Exclusion criteria were previous bariatric surgery, patients subjected to other types of bariatric surgery and those who had no pre or postoperative upper digestive endoscopy. The epidemiological variables were: sex, age, body mass index, type 2 diabetes mellitus or impaired glucose tolerance, and preoperative dyslipidemia. Results: The preoperative upper endoscopy was normal in 26.4% of the patients. Among endoscopic alterations, the hiatus hernia was the most prevalent followed by non-erosive gastritis. The postoperative upper endoscopy was normal in 40.9% and stenosis was the most prevalent followed by marginal ulcer. Correlation on pre and postoperative endoscopies, was found 100% reduction of hiatal hernias and 88% of esophagitis. There was no statistical significance in relationship to anastomotic stenosis with preoperative other variables. Conclusions . There was significant decrease in postoperative hiatus hernia, erosive esophagitis, non-erosive esophagitis, erosive gastritis and non-erosive gastritis with the operation. Stenosis of the gastrojejunostomy anastomosis was the most prevalent postoperative complication with no correlation with preoperative variables.

Assessment of the hygienic and periodontal status of the oral cavity in patients diagnosed with pemphigus vulgaris during remission and exacerbation

2020 ◽  
Vol 1 (12) ◽  
pp. 24-26
Author(s):  
I. M. Makeeva ◽  
E. G. Margaryan ◽  
E. I. Selifanova ◽  
A. I. Gireeva ◽  
N. P. Teplyuk ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Oral Hygiene ◽  
Pemphigus Vulgaris ◽  
Controlled Study ◽  
Control Group ◽  
Periodontal Status ◽  
Average Value ◽  
Mucous Membranes ◽  
Mixed Saliva ◽  
Periodontal Indices

Introduction. Pemphigus vulgaris is characterized by the appearance of blisters on the skin and mucous membranes, which burst forming extensive erosions and ulcers. The painful erosions appearance complicates eating, speaking, oral hygiene and also favors the increase in soft and hard plaque, the presence of gingivitis, periodontitis, and changes in the oral microbiocenosis.Purpose of the study is the analysis of the hygienic and periodontal status of the oral cavity in patients diagnosed with pemphigus vulgaris based on an index score.Material and methods. The prospective cohort controlled study involved 20 patients with a confirmed diagnosis of pemphigus vulgaris, 10 of whom were at the stage of exacerbation of the disease and 10 at the stage of clinical remission, as well as 10 patients without oral mucosal pathology made up the control group. The pH of mixed saliva was measured and the average value of hygienic and periodontal indices (Silness-Loe, PBI, PMA, PI) was also determined.Results. The hygienic and periodontal status of patients with pemphigus vulgaris is worse than that of the control group.

scholarly journals Pemphigus vulgaris presenting as esophageal ulceration. Report of an underdiagnosed manifestation

2021 ◽  
Vol 84 (2) ◽  
pp. 365-366
Author(s):  
C Leal ◽  
M Silva ◽  
S Barbeiro ◽  
H Vasconcelos
Keyword(s):  
Immunosuppressive Therapy ◽  
Rare Case ◽  
Pemphigus Vulgaris ◽  
True Prevalence ◽  
Esophageal Involvement ◽  
Esophageal Ulceration ◽  
Mucosal Involvement ◽  
Acid Suppression Therapy ◽  
Mucous Membranes ◽  
Esophageal Ulcers

Pemphigus vulgaris (PV) is a rare autoimmune blistering disorder of the skin and mucous membranes. The true prevalence of esophageal involvement is unknown; esophageal symptoms almost always occur in the context of oral mucosa involvement. We report the case of a 66-year-old man with cutaneous blisters and esophageal symptoms that did not respond to acid suppression therapy. Esophagogastroduodenoscopy showed esophageal ulcers and mucosal desquamation. Biopsies were consistent with the diagnosis of PV. The patient was started on immunosuppressive therapy, achieving remission. This represents a rare case of esophageal involvement of PV without mucosal involvement and draws attention to a rare cause of dysphagia, which can be fatal if left untreated

Foundation for the Prevention and Pathological Aspects of Diseases of the Mucous Membranes of the Oral Cavity (Review)

2020 ◽  
Vol 3 (6) ◽  
pp. 8-11
Author(s):  
Bakaev Zh. N.
Keyword(s):  
Oral Cavity ◽  
Rural Women ◽  
Rural Areas ◽  
Southern China ◽  
Age Groups ◽  
Urban Residents ◽  
Volgograd Region ◽  
Mucous Membranes ◽  
The Russian Federation ◽  
Two Age Groups

According to the authors, the prevalence of SOPR diseases is from 3 to 20%.In a study of 1573 residents of southern China in two age groups who use tobacco and alcohol, the incidence of SOPR was higher among men living in rural areas compared to urban residents. Among women aged 35-44 years, the incidence was higher in urban women, and in the 65-77-year-old group in rural women. In the course of studies in Brazil, among 335 patients older than 60 years, 646 diseases of the SOPR were identified. Similar results were obtained in the analysis of SOPR diseases in the Volgograd region of the Russian Federation

Interdisciplinary approach to the management of a patient with Sjogren’s syndrome: a clinical case

2021 ◽  
Author(s):  
N. Y. Emelyanova ◽  
T. E. Kozyrieva ◽  
O. V. Stepanova ◽  
N. V. Zorenko
Keyword(s):  
Oral Cavity ◽  
Salivary Glands ◽  
Sjögren’S Syndrome ◽  
Clinical Case ◽  
Sjögren's Syndrome ◽  
Interdisciplinary Approach ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Mucous Membranes ◽  
Sjögren‘S Syndrome

Dryness of the mucous membranes (in mouth, nose, genitals in women) and skin are the most common complaints of patients with Sjogren’s disease — a multisystem immune‑mediated disorder that causes anxiety and concern associated with the difficulties of initial diagnosis. The authors present a clinical case of a patient with primary Sjogren’s syndrome, a large number of symptoms of digestive diseases, complaints of dryness of mucous membranes, in particular the oral cavity. The diagnosis was confirmed by allied specialists such as ophthalmologist, gynecologist, rheumatologist, dentist. Detailed dental examination revealed the main dental complaints (constant dry mouth, galitos, changes in taste), clinical condition (dryness of the red border of the lips, swelling of the oral mucosa, changes in the relief of the gums), decreased secretory activity and significant reduction of unstimulated salivation with a moderate level of stimulated salivation. It is noted that a significant decrease in sialometry (0.01 ml per minute) and functional activity of the small salivary glands (up to 18) confirms the presence of true xerostomia. Micro‑crystallization of saliva revealed disorganization of irregularly shaped structures, as well as a significant number of organic inclusions, which indicates a violation of homeostasis in the oral cavity. Given the results of ultrasound examination of the large salivary glands and the absence of enlargement and swelling of the glands during clinical examination, we can assume that the destructive damage to the glands is not so pronounced, evacuation function of the gland is not reduced, but the amount of secretion is significantly reduced. To provide medical aid to patients with Sjogren’s syndrome, the accessibility of the qualified consultation is important and required, with conduction of comprehensive examinations by allied specialists, including a dentist.  

scholarly journals Noninvasive assessment of oesophageal varices presence and size in patients with liver cirrhosis using right liver lobe/serum albumin concentration

2007 ◽  
Vol 64 (7) ◽  
pp. 453-457
Author(s):  
Tamara Alempijevic ◽  
Vladislava Bulat ◽  
Nada Kovacevic ◽  
Rada Jesic ◽  
Srdjan Djuranovic ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Oesophageal Varices ◽  
Digestive Endoscopy ◽  
Liver Lobe ◽  
Albumin Ratio ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Upper Digestive Endoscopy ◽  
The Right

Background/Aim. Liver cirrhosis is a chronic, progressive disease and it is usually accompanied by portal hypertension. The development of oesophageal varices (OV) is one of the major complications of portal hypertension. Cirrhotic patients should be screened for the presence of OV when portal hypertension is diagnosed. In order to reduce the increasing burden that endoscopy units have to bear, some studies have attempted to identify parameters for noninvasive prediction of OV presence. The aim of our study was to evaluate the value of biochemical and ultrasonography parameters for prediction of OV presence. Methods. This study included 58 cirrhotic patients who underwent a complete biochemical workup, ultrasonography examination and upper digestive endoscopy. Right liver lobe diameter/albumin ratio was calculated and its correlation to the presence and degree of OV, and Child-Pugh score of liver cirrhosis explored. Results. The mean age of the patients included in the study was 53.07?13.09 years; 40 were males and 18 females. In the Child-Pugh class A were 53.4% patients, class B 39.7%, whereas 6.9% were in the class C. In 24.1% of the patients no OV were identified by upper digestive endoscopy, 19% had OV grade I, 34.5% grade II, 20.7% grade III, and 1.7% OV grade IV. The mean value of the right liver lobe diameter/ albumin ratio was 5.43?1.79 (range of 2.76?11.44). Statistically significant correlation (p < 0.01) was confirm by Spearman's test between OV grade and calculated index (? = 0.441). Conclusion. The right liver lobe diameter/albumin ratio is a noninvasive parameter which provides an accurate information pertinent to the determination of OV presence and their grading in patients with liver cirrhosis. .

scholarly journals Esophageal Pemphigus Vulgaris: A Rare Etiology of Upper Gastrointestinal Hemorrhage

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Jennifer Rose F. Del Castillo ◽  
Muhammad Nadeem Yousaf ◽  
Fizah S. Chaudhary ◽  
Nahar Saleh ◽  
Lawrence Mills
Keyword(s):  
Early Recognition ◽  
Gastrointestinal Symptoms ◽  
Pemphigus Vulgaris ◽  
Diagnostic Endoscopy ◽  
Presenting Symptoms ◽  
Esophageal Involvement ◽  
Asymptomatic Patients ◽  
Mucosal Surfaces ◽  
Early Endoscopy ◽  
Upper Gastrointestinal

Pemphigus vulgaris (PV) is an autoimmune blistering disorder of the skin and mucosal surfaces characterized by acantholysis (loss of adhesion between epidermal cells). Esophageal involvement of PV is an underdiagnosed entity as routine diagnostic endoscopy is not recommended in asymptomatic patients. Dysphagia and odynophagia are common presenting symptoms; however, upper gastrointestinal bleeding (UGIB) associated with esophageal involvement of PV without a history of mucosal blistering is extremely uncommon. We present a case of esophageal involvement of PV associated with active UGIB that was diagnosed on endoscopic evaluation. This case illustrated the importance of early endoscopy to identify the esophageal involvement of PV especially in patients with preexisting disease who present with gastrointestinal symptoms such as dysphagia, odynophagia, and hematemesis. Early recognition of esophageal involvement of PV and initiation of corticosteroid and/or immunosuppressant therapy may improve the outcome of the disease.

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