PETER WITT, M.D.; EAPEN THOMAS, M.D.
To the editor: Schneider and colleagues (1) have emphasized that the diagnosis of scleroderma should be considered when the lower two thirds of the esophagus (the smooth muscle segment) shows aperistalsis and low pressure in the lower sphincter. However, similar changes may be caused by other rheumatic diseases (2-5). One fact that has not been recognized in scleroderma is that severe skin involvement in the cervical region may indirectly affect upper esophageal function.
We recently saw a patient with classical features of scleroderma whose major symptom was transfer dysphagia and nasal regurgitation. Esophageal manometry showed normal lower esophageal sphincter pressure,
WITT P, THOMAS E. Scleroderma and the Esophagus. Ann Intern Med. ;101:566–567. doi: 10.7326/0003-4819-101-4-566_2
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Published: Ann Intern Med. 1984;101(4):566-567.
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