An unusual cause of pseudoachalasia: The Alport syndrome-diffuse leiomyomatosis association

Rita G. Sousa, Pedro C. Figueiredo, Pedro Pinto-Marques, Tânia Meira, Luís A. Novais, Ana I. Vieira, Carlos Luz, Paula Borralho, João Freitas

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Alport syndrome (AS) is a hereditary disease characterized by glomerular nephropathy progressing to end-stage renal disease, frequently associated with sensorineural deafness and ocular abnormalities. Rarely, AS coexists with diffuse leiomyomatosis, a benign proliferation of smooth muscle in the gastrointestinal tract, mostly of the oesophagus, but also of the tracheobronchial tree and the female genital tract. Patients with this association have been shown to have contiguous gene deletion involving both COL4A5 and COL4A6 genes. The authors report the case of a 25-year-old man with AS and long-standing dysphagia. The patient received a renal transplant at the age of 23 because of end-stage renal disease. Clinical assessment as well as endoscopic, manometric and radiologic studies suggested the diagnosis of achalasia, which was treated by Heller's myotomy with Dor fundoplication. Postprocedure dysphagia led to an endoscopic ultrasound that showed diffuse thickening of the second layer, resulting in the hypothesis of oesophageal leiomyomatosis. The diagnosis was confirmed through histological study of endoscopic biopsies and genetic analysis.

Original languageEnglish
Pages (from-to)1352-1357
Number of pages6
JournalEuropean Journal of Gastroenterology and Hepatology
Volume25
Issue number11
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Alport syndrome
  • Diffuse leiomyomatosis
  • Pseudoachalasia

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