# Intralesional Corticosteroid Therapy for Isolated Immunoglobulin G4-Related Esophageal Involvement: A Novel Approach to a Rare Condition

## TL;DR

A novel treatment combining intralesional steroids and balloon dilation successfully managed a rare case of immunoglobulin G4-related esophageal disease.

## Contribution

This paper introduces a new treatment approach for immunoglobulin G4-related esophageal disease using intralesional steroids.

## Key findings

- The patient showed prolonged clinical stability with the novel treatment approach.
- Systemic and topical steroids were poorly tolerated by the patient.
- Combining intralesional steroids with serial balloon dilation proved effective for managing the condition.

## Abstract

Immunoglobulin G4-related disease is a chronic, systemic immune-mediated condition. Esophageal involvement is considered rare and often poses major diagnostic and therapeutic challenges. We present an 81-year-old male patient with isolated esophageal immunoglobulin G4-related disease with extended clinical and endoscopic follow-up for 6 years, who had poor tolerance to systemic and topical steroids. The patient was successfully treated using a combination of intralesional steroids and serial balloon dilations spaced at long intervals. This approach, which has not been previously reported in this condition, resulted in prolonged clinical stability over an extended period.