A 40-year-old woman with no relevant medical history.
The patient came to the Primary Care clinic due to a clinical picture of dyspepsia with epigastric pain and recurrent heartburn for 10 days.
The anamnesis ruled out transgress diets, ingestion of drugs or gastrolesive substances, and the presence of organic symptoms or clinical alarm data.
Physical examination was normal.
The patient was diagnosed with uninvestigated dyspepsia.
The patient was treated with hygienic-dietetic measures 20 mg/day for 4 weeks and referred for review.
The patient reported mild clinical improvement.
There was an increase in radiation dose to full doses and a prokinetic drug was prescribed.
The patient was cited in 4 weeks for a new review, which showed the presence of mechanical oropharyngeal dysphagia as an alarm sign.
An upper gastrointestinal endoscopy was performed preferentially, which showed the presence of an esophageal exudate in the proximal 2/3.
Samples of the lesions were taken by brushing for pathological study and culture, which confirmed the diagnosis of candidiasis.
1.
The patient was treated with fluconazole 100 mg/day for 21 days and pantoprazole 40 mg/day orally, achieving complete remission.
diagnosis and radiological study of CD were completed the study of its associated causes (neurological causes of the abdomen, diabetic liver disease, systemic diseases, depression, etc.) by anamnesis, physical examination, laboratory tests, renal function
The results of all complementary tests were negative.
After completing the study, the only risk factor found was treatment with proton pump inhibitors (PPI).
Finally the patient was diagnosed with CD in immunocompetent patient.
In the reviewed literature, patients with CD related to PPI use had undergone this treatment for at least 2 months6-8 (such as our patient).
We decided to discontinue this treatment after clinical resolution and subsequently perform a normal control ADD.
