A 53-Year-Old Man with Nocturnal Cough Undergoes an Upper Endoscopy

A 53-year-old man with nocturnal cough undergoes an upper endoscopy with esophageal biopsy.  Light microscopy of the tissue specimen shows elongation of the lamina propria papillae with several eosinophils and neutrophils scattered within the squamous epithelium.  The patient takes metformin and enalapril for diabetes mellitus and hypertension, respectively.  He is started on pantoprazole, and after 2 weeks his cough symptoms resolve.  Which of the following was the most likely cause of his symptoms?

A) Absent esophageal peristaltic movements
B) Allergen-mediated esophageal disease
C) Gastroesophageal junction incompetence
D) Mucosal disruption from fungal infection
E) Mucosal disruption from viral infection
F) Pill-induced esophageal mucosa damage

Correct Answer:

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