A 34-year-old female presents with hypertension, pinched facies and progressive dysphagia with decreased tone of lower esophageal sphincter (LES) The clinical diagnosis is?
Ans. A SclerodermaRef: CMDT 2019 page 323* Pinched facies with hypertension points to presence of scleroderma. The tone of LES is reduced in scleroderma due to fibrosis.* Choice B and C can lead to GERD but it does not have other features like systemic hypertension.* Choice D presents with chest pain and dysphagia and is hence ruled out.
Scleroderma
Hiatus hernia
Rolling hernia
Diffuse esophageal spasm
Misc.