NSAID-Induced Esophagitis: An Uncommon Cause of Severe Eosinophilic Infiltration

Ramos J.A.; Arantes V. · Revista Colombiana de Gastroenterologia (2025) · DOI: 10.22516/25007440.1300

Resumen

Background: Drug-induced esophagitis is an underdiagnosed condition, largely due to the inadequate clinical assessment these patients often receive. A thorough medical history is essential for establishing a correct diagnosis. Early identification is crucial for proper management and counseling, helping to prevent recurrent episodes that may significantly impair quality of life. Upper endoscopy and histopathological examination are fundamental to clarifying the diagnosis and excluding other conditions with similar presentations. Severe eosinophilic infiltration, although uncommon in drug-induced esophagitis, may resemble other disorders such as eosinophilic esophagitis. Case report: We present the case of a young patient who developed severe dysphagia following exposure to nonsteroidal anti-inflammatory drugs (NSAIDs). Upper endoscopy revealed pronounced inflammation with marked eosinophilic infiltration on histopathological evaluation. Symptoms resolved fully after discontinuing NSAIDs and initiating proton pump inhibitor therapy, with no recurrence over the medium- to long-term follow-up. Conclusions: Drug-induced esophagitis should be recognized as a potential cause of severe eosinophilic infiltration and may even mimic the endoscopic and histologic profile traditionally associated with other conditions, such as eosinophilic esophagitis.