Case of the Month: Older Adult With Heartburn
Case of the Month: Older Adult With Heartburn
By Numbereye Numbere, MBBS (PGY-3), Brandon Sprung, MD, and Rossana Kazemimood, MD
Clinical History
An older woman presented to the clinic with complaints of dysphagia and burning retrosternal pain.
Past Medical History
The patient has a history of multiple medical conditions, including chronic pain, hypertension, and hypothyroidism, for which she takes several medications. An esophagogastroduodenoscopy was performed.
Recent History
Findings on endoscopy include mucosal plaques and rings in the mid-esophagus (Fig. 1-3). On microscopy, the esophageal epithelium has a dual-tone appearance with a superficial layer of necrotic deeply eosinophilic squamous cells overlying a deep layer of viable epithelium (Fig. 4-6), separated on occasion by a band of necrotic, spongiotic squamous cells and neutrophils (Fig. 6).
