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.