Muhammed SAÇIKARA, Yaşar NAZLIGÜL, Güler KIZILCA, Oktay BULUR

Doksisiklin özofajiti: İki Olgu nedeniyle literatürün gözden geçirilmesi

İlaca bağlı özofagus hasarı literatürde sık görülmemekle birlikte yol açabileceği komplikasyonlar açısından önemli bir durumdur. Doksisiklin alırken ülseratif özofajit saptanan iki hasta rapor ettik. Her iki hasta da kliniğimize retrosternal ağrı, odinofaji ve disfaji şikâyetleriyle başvurdu. Semptomlar birinci hastada tedavinin 3. , ikinci hastada 2. gününde gelişmişti. Endoskopide birinci hastada özofagus üst 1/3, ikinci hastada ise orta 1/3 segmentte ülserler görüldü. Anamnez ve endoskopik bulgularla, hastalara doksisiklin kullanımına bağlı ilaç özofajiti teşhisi kondu; almakta olduğu tedavileri durduruldu. İlacın kesilmesinden sonra ilerleyen günlerde semptomları düzeldi. İki hafta sonra yapılan kontrol endoskopilerinde özofagus, tamamen normaldi. Doksisiklin kimyasal özofajite neden olabilir. İlaç özofajiti önlenebilir bir hastalıktır.

Doxycycline-induced esophagitis: Report of two cases and review of the literature

Although it is not so frequent in medical literature, drug-induced esophageal injury is important, because of its possible complications. Here, we reported two patients with ulcerative esophagitis secondary to doxycycline use. Both patients applied to outpatient clinic with retrosternal pain, odynofagia and dysphagia. Symptoms had been developed after three days of doxicycline treatment in the first patient, and after two days in the second patient. Upper gastrointestinal endoscopy revealed ulcers in patient 1 at the upper 1/3 segment of esophagus and in patient 2 at the middle 1/3 segment of esophagus. Based on the endoscopic findings, the patients were diagnosed as drug-induced esophageal injury resulting from doxycycline treatments. Doxycycline treatments were stopped and lansoprazole and sucralfate was started.�􀀷� � Their symptoms improved in a few days following cessation of the drug. The esophagus was found as completely normal in control endoscopy performed after two weeks. Doxycycline can cause chemical esophagitis. Drug-induced esophagitis is a preventable cause of morbidity.

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1. Jaspersen D. Drug-induced oesophageal disorders: Pathogenesis, incidence, prevention, and management. Drug Safety 2000;22:237–49.
2. Eng J, Sabanathan S. Drug-induced esophagitis. Am J Gastroenterol 1991;86:1127-33.
3. Kearney D, McDonald GB. Esophageal disorders caused by infection, systemic illness, medications, radiation, and trauma. In: Feldman M, Freidman LS, Sleisenger MH, eds. Gastrointestinal and Liver Disease Pathophysiology, Diagnosis, Management. Philadelphia: Saunders, 2002:623-47.
4. Sayın I, Doğanay Ş, Değertekin H. Doksisiklin kullanımına bağlı özofagus ülseri. Türkiye Klin Gastroenterohepatol Dergi 2009;16:80-3.
5. Vãlean S, Petrescu M, Cãtinean A, Chira R, Mircea PA. Pill esophagitis. Rom J Gastroenterol 2005;14:159-63.
6. Bott S, Prakash C, McCallum RW. Medication-induced esophageal injury: survey of the literature. Am J Gastroenterol 1987;82:758-63.
7. Ollyo JB, Fontolliet C, Monnier P, Wellinger J, Restellini A, Gonvers JJ, et al. [Drug-induced esophagitis and its complications. Retrospective study of 30 case reports and review of 650 published cases (1970-1987)] Schweiz Rundsch Med Prax 1990;79:394-7.