Markedly Effective Steroid Treatment of Three Patients with Allergy-related Jackhammer Esophagus

Yasushi Funaki; Naotaka Ogasawara; Yurika Kawamura; Takashi Yoshimine; Yasuhiro Tamura; Shinya Izawa; Takuji Tsuyuki; Masahide Ebi; Makoto Sasaki; Kunio Kasugai

doi:10.2169/internalmedicine.3865-19

CASE REPORTS

Markedly Effective Steroid Treatment of Three Patients with Allergy-related Jackhammer Esophagus

Yasushi Funaki, Naotaka Ogasawara, Yurika Kawamura, Takashi Yoshimine, Yasuhiro Tamura, Shinya Izawa, Takuji Tsuyuki, Masahide Ebi, Makoto Sasaki, Kunio Kasugai

Author information

Yasushi Funaki
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
Naotaka Ogasawara
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
Yurika Kawamura
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
Takashi Yoshimine
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
Yasuhiro Tamura
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
Shinya Izawa
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
Takuji Tsuyuki
Department of Surgical Pathology, Aichi Medical University School of Medicine, Japan
Masahide Ebi
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
Makoto Sasaki
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
Kunio Kasugai
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan

Keywords: eosinophilic esophagitis, gastroesophageal reflux disease, high-resolution manometry, Jackhammer esophagus, prednisolone

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 5 Pages 633-639

DOI https://doi.org/10.2169/internalmedicine.3865-19

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Abstract

We experienced marked efficacy with steroid treatment of three patients with jackhammer esophagus (JHE). An esophageal biopsy revealed eosinophilic esophagitis (EoE) in two patients. One of the patients without EoE had eosinophilia and an increased serum immunoglobulin E level, and endoscopic ultrasonography revealed thickening of the esophageal muscularis propria. Esophageal manometry was used to diagnose all cases of JHE. Treatment consisted of steroid administration, which improved the symptoms and resolved the esophageal muscularis propria thickening in all patients. The esophageal manometry findings also normalized following treatment. Allergic diseases, including EoE, were assumed to have caused JHE.

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