Achalasia in a woman presenting with vitiligo: A case report

Suprapto, Bambang; Aswin, Amalia

doi:10.1016/j.ijscr.2020.09.052

Cited by 1 publication

(1 citation statement)

References 17 publications

(31 reference statements)

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“…In most cases, pathology is accompanied by neuronal antibodies that contribute to the destruction of the myenteric plexus. For achalasia, multiple reports are associated with autoimmune diseases such as polyglandular autoimmune syndrome Type II 27 ,thyroid disease 28 , vitiligo 29 , and common variable immunodeficiency 30 . In previous studies, and also the present contribution, several systemic biomarkers of immune response were detected at higher levels in patients with achalasia (Fig.…”

Section: Discussionmentioning

confidence: 99%

Achalasia alters physiological networks depending on sex

Furuzawa-Carballeda,

Barajas-Martínez,

Olguín-Rodríguez

et al. 2024

Sci Rep

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Achalasia is a rare esophageal motility disorder for which the etiology is not fully understood. Evidence suggests that autoimmune inflammatory infiltrates, possibly triggered by a viral infection, may lead to a degeneration of neurons within the myenteric plexus. While the infection is eventually resolved, genetically susceptible individuals may still be at risk of developing achalasia. This study aimed to determine whether immunological and physiological networks differ between male and female patients with achalasia. This cross-sectional study included 189 preoperative achalasia patients and 500 healthy blood donor volunteers. Demographic, clinical, laboratory, immunological, and tissue biomarkers were collected. Male and female participants were evaluated separately to determine the role of sex. Correlation matrices were constructed using bivariate relationships to generate complex inferential networks. These matrices were filtered based on their statistical significance to identify the most relevant relationships between variables. Network topology and node centrality were calculated using tools available in the R programming language. Previous occurrences of chickenpox, measles, and mumps infections have been proposed as potential risk factors for achalasia, with a stronger association observed in females. Principal component analysis (PCA) identified IL-22, Th2, and regulatory B lymphocytes as key variables contributing to the disease. The physiological network topology has the potential to inform whether a localized injury or illness is likely to produce systemic consequences and the resulting clinical presentation. Here we show that immunological involvement in achalasia appears localized in men because of their highly modular physiological network. In contrast, in women the disease becomes systemic because of their robust network with a larger number of inter-cluster linkages.

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Section: Discussionmentioning

confidence: 99%