Clin Endosc.  2014 Sep;47(5):452-454. 10.5946/ce.2014.47.5.452.

Esophageal Involvement of Pemphigus Vulgaris Associated with Upper Gastrointestinal Bleeding

  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 2Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.


Esophageal involvement of pemphigus vulgaris is rare, and when present, the most common presenting symptoms reported in the medical literature are odynophagia and dysphagia. Here, we present two cases of pemphigus vulgaris presenting with upper gastrointestinal hemorrhage because of esophageal involvement of the disease. In case 1, a 41-year-old female patient with a prior diagnosis of pemphigus vulgaris presented with hematemesis. Esophagogastroduodenoscopy showed diffuse mucosal exfoliation and oozing bleeding of the oropharynx and esophagus. The patient recovered after the administration of high-dose corticosteroids and immunosuppressants. In case 2, a 30-year-old female patient with known pemphigus vulgaris also presented with hematemesis, showing similar endoscopic findings to the first case. She also responded to the same treatment. Esophageal involvement of pemphigus vulgaris responds to high-dose corticosteroids and immunosuppressants. Thus, in patients with pemphigus vulgaris with signs or symptoms of upper gastrointestinal bleeding, an early endoscopy for the evaluation of esophageal involvement is beneficial.


Pemphigus; Esophageal involvement; Upper gastrointestinal bleeding

MeSH Terms

Adrenal Cortex Hormones
Deglutition Disorders
Endoscopy, Digestive System
Gastrointestinal Hemorrhage
Immunosuppressive Agents
Adrenal Cortex Hormones
Immunosuppressive Agents


  • Fig. 1 Endoscopic findings. (A) Diffuse swelling of the larynx with oral desquamation. (B) Multiple erosions and shallow ulcers with exfoliation of the esophageal mucosal tissue. (C) Diffuse subepithelial hemorrhage of the esophagus.

  • Fig. 2 Endoscopic findings. (A) Mucosal abrasions on the oral cavity wall. (B) Erythematous mucosa with severe edema of the larynx. (C) Linear ulceration in the esophagus covered with exudate.

  • Fig. 3 Endoscopic findings. (A) Improvement of laryngeal edema and oral mucosal lesions. (B) Resolved status of mucosal lesions in the esophagus.


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