REVERSIBLE ESOPHAGEAL MOTILITY DISORDER IN A PATIENT WITH SARCOIDOSIS

We report the case of a patient who presented with new onset of dyspha gia for solids and liquids, Her condition was subsequently diagnosed a s sarcoidosis on the basis of granulomatous inflammation in tissue obt ained from transbronchial fine needle aspiration, noncaseating granulo mas in a full-thickness lip biopsy, mild uveitis on slit lamp examinat ion, and serum angiotensin-converting enzyme activity of 120 U/L, Esop hageal manometry revealed a nonspecific esophageal motility disorder w ith 60% nontransmitted contractions and a lower esophageal sphincter t hat failed to relax with wet swallows, The patient was treated with 40 mg prednisone per day, and within 2 wk her dysphagia had markedly imp roved, Prednisone was continued,vith a slow taper, and after 1 month h er dysphagia had resolved and her esophageal manometry was normal, To our knowledge, this is the first case of sarcoidosis presenting with d ysphagia and documented esophageal dysmotility in which symptoms and m anometric abnormalities normalized after therapy with systemic cortico steroids.