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A case of chronic cough caused by achalasia misconceived as gastroesophageal reflux disease.

Kwon HY, Lim JH, Shin YW, Kim CW - Allergy Asthma Immunol Res (2014)

Bottom Line: Finally, she was diagnosed with achalasia.Achalasia is a rare disease accompanied by dysphagia or regurgitation.If cough presumably due to GERD does not respond to treatment, or if the cause of chronic cough is uncertain, physicians should suspect achalasia.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.

ABSTRACT
Cough is one of the most common symptoms that causes patients to seek outpatient medical care. If cough persists longer than 8 weeks, common causes of chronic cough, such as upper airway cough syndrome, asthma, and gastroesophageal reflux disease (GERD), should be considered. Although not a common cause of chronic cough, achalasia may cause symptoms very similar to reflux that can lead to its misdiagnosis as GERD. In this report, a 40-year-old woman presenting with chronic cough was initially diagnosed with GERD; however, her symptoms were refractory to conventional GERD treatment. Finally, she was diagnosed with achalasia. Her cough improved completely after pneumatic dilatation. Achalasia is a rare disease accompanied by dysphagia or regurgitation. If cough presumably due to GERD does not respond to treatment, or if the cause of chronic cough is uncertain, physicians should suspect achalasia.

No MeSH data available.


Related in: MedlinePlus

Multiple acute esophageal ulcers were noted on the first esophagogastroduodenoscopic examination for cough. This was misinterpreted as esophageal ulcers and chronic cough associated with gastroesophageal reflux disease.
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Figure 2: Multiple acute esophageal ulcers were noted on the first esophagogastroduodenoscopic examination for cough. This was misinterpreted as esophageal ulcers and chronic cough associated with gastroesophageal reflux disease.

Mentions: A previously healthy 40-year-old woman was admitted to the Gastrointestinal Center for cough and heartburn, which were aggravated at night. Her symptoms had been ongoing for over 4 months. She also complained of rhinorrhea and salivation during sleep, acid reflux during coughing, and intermittent dysphagia. On her first visit, her vital signs were stable and white blood cell (WBC) count was 14,440/mm3 (neutrophil 82.0%, lymphocyte 13.8%). All other laboratory data were unremarkable. Chest X-ray revealed haziness in the right middle and lower lobe, suggesting community acquired pneumonia (Fig. 1). EGD revealed multiple acute ulcers on the esophagus and chronic superficial gastritis (Fig. 2). She was treated with levofloxacin for pneumonia and with a PPI and calcium channel blocker for esophageal ulcers and GERD.


A case of chronic cough caused by achalasia misconceived as gastroesophageal reflux disease.

Kwon HY, Lim JH, Shin YW, Kim CW - Allergy Asthma Immunol Res (2014)

Multiple acute esophageal ulcers were noted on the first esophagogastroduodenoscopic examination for cough. This was misinterpreted as esophageal ulcers and chronic cough associated with gastroesophageal reflux disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214979&req=5

Figure 2: Multiple acute esophageal ulcers were noted on the first esophagogastroduodenoscopic examination for cough. This was misinterpreted as esophageal ulcers and chronic cough associated with gastroesophageal reflux disease.
Mentions: A previously healthy 40-year-old woman was admitted to the Gastrointestinal Center for cough and heartburn, which were aggravated at night. Her symptoms had been ongoing for over 4 months. She also complained of rhinorrhea and salivation during sleep, acid reflux during coughing, and intermittent dysphagia. On her first visit, her vital signs were stable and white blood cell (WBC) count was 14,440/mm3 (neutrophil 82.0%, lymphocyte 13.8%). All other laboratory data were unremarkable. Chest X-ray revealed haziness in the right middle and lower lobe, suggesting community acquired pneumonia (Fig. 1). EGD revealed multiple acute ulcers on the esophagus and chronic superficial gastritis (Fig. 2). She was treated with levofloxacin for pneumonia and with a PPI and calcium channel blocker for esophageal ulcers and GERD.

Bottom Line: Finally, she was diagnosed with achalasia.Achalasia is a rare disease accompanied by dysphagia or regurgitation.If cough presumably due to GERD does not respond to treatment, or if the cause of chronic cough is uncertain, physicians should suspect achalasia.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.

ABSTRACT
Cough is one of the most common symptoms that causes patients to seek outpatient medical care. If cough persists longer than 8 weeks, common causes of chronic cough, such as upper airway cough syndrome, asthma, and gastroesophageal reflux disease (GERD), should be considered. Although not a common cause of chronic cough, achalasia may cause symptoms very similar to reflux that can lead to its misdiagnosis as GERD. In this report, a 40-year-old woman presenting with chronic cough was initially diagnosed with GERD; however, her symptoms were refractory to conventional GERD treatment. Finally, she was diagnosed with achalasia. Her cough improved completely after pneumatic dilatation. Achalasia is a rare disease accompanied by dysphagia or regurgitation. If cough presumably due to GERD does not respond to treatment, or if the cause of chronic cough is uncertain, physicians should suspect achalasia.

No MeSH data available.


Related in: MedlinePlus