An Uncommon Cause of Dysphagia

Dysphagia is a frequent indication for a referral to a gastroenterologist. The most common etiologies of dysphagia include gastroesophageal reflux disease, eosinophilic esophagitis (EoE), or structural disorders of the esophagus. We present a case of refractory dysphagia in a patient with a history of Sjogren’s disease and autoimmune hepatitis. Upper endoscopy showed crepe paper appearance of the esophagus raising suspicion for EoE; however, biopsies revealed lymphocytic esophagitis (LE). As LE is a rare entity, optimal treatment remains unknown. Nonetheless, applying the common methods used to treat EoE including proton pump inhibitors, topical steroids, and esophageal dilations improved the patient’s symptoms.