Esophageal Pemphigus Vulgaris: A Rare Etiology of Upper Gastrointestinal Hemorrhage

Table 1

Studies with esophageal involvement of pemphigus vulgaris associated with upper gastrointestinal bleeding.

Study	Year	Age (year)/sex	Presentation	Preexisting PV	Endoscopic findings	DIF	IIF	Treatment
Wood et al. [6]	1982	56/F	Hematemesis	Yes, both cutaneous and mucosal	Multiple circumferential erythematous and granularity of lower end of the esophagus and area of discrete ulceration above the EGJ	Positive	Negative	Sucralfate and antacid
Venkataram et al. [7]	2001	26/F	Hematemesis and melena	No	Friable mucosa with erythema and linearmucosal ulcers	NA	Negative	Prednisolone, cyclophosphamide, and antacids
Tageja et al. [8]	2010	69/F	Hematemesis, peptic ulcer disease	No	Multiple hemorrhagic bullae in the midesophagus	NA	NA	Prednisone
Mohan et al. [9]	2013	48/F	Hematemesis	Yes, both cutaneous and mucosal lesions	Oropharyngeal ulcers and mucosal desquamation	NA	NA	Steroids and PPI
Chang et al. [2]	2014	41/F; 30/F	Hematemesis	Yes, cutaneous PV	Mucosal edema and erythema on the esophagus and larynx with desquamation. Upper esophageal sphincter to lower esophagus with diffuse exfoliation of mucosa with multiple linear ulcer and erosions.	NA	NA	IV hydrocortisone and mycophenolate mofetil
Del castillo et al. (present case)	2020	85/F	Hematemesis	Yes	Multiple shallow ulcers and grouped blisters throughout the proximal and midesophageal mucosa.	NA	NA	Systemic steroids and proton pump inhibitor

PV, pemphigus vulgaris; DIF, direct immunofluorescence; IIF, indirect immunofluorescence; NA, not available; PPI, proton pump inhibitors.