Esophageal involvement in Wegener's granulomatosis: A case report and review of the literature

Wegener's granulomatosis is characterized by a granulomatous arteritis invo lving the upper and lower respiratory tracts, progressive glomerulonephriti s and systemic symptoms attributable to small vessel vasculitis. Although m ultisystemic manifestations are frequent, involvement of the gastrointestin al tract is uncommon. Cases have been reported of intestinal perforation, u lceration and hemorrhage. A patient whose initial presentation of Wegener's granulomatosis was odynophagia secondary to esophageal vasculitis is descr ibed. Endoscopy revealed multiple punched out ulcerations in the esophagus, which resolved with standard therapy for systemic Wegener's granulomatosis . There are only two previous reports of symptomatic esophageal vasculitis in patients with Wegener's granulomatosis. These reports illustrate the nee d to consider odynophagia as a reflection of disease activity as opposed to complications of immunosuppressive therapy.