Das Tetracyclin-Ulkus der Speiseröhre

Giger, M; Sonnenberg, Amnon; Brändli, H; Singeisen, M; Güller, R; Al, Blum

doi:10.1055/s-0028-1104828

Cited by 28 publications

(4 citation statements)

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“…Direct irritant effect of medication due to prolonged contact with esophageal mucosa appears to be the most likely factor. However, the acidic nature of some medications such as tetracycline hydrochloride and its derivatives [3,7,[15][16][17][18], ascorbic acid [81, and ferrous sulfate [6] may also play a role. Slow clearance of the medication due to the large size of the tablet or abnormal esophageal motility may contribute to prolonged contact between the ingested medication and the esophageal mucosa.…”

Section: Discussionmentioning

confidence: 99%

Medication-induced esophagitis

Agha

Wilson

Nostrand

1986

Gastrointest Radiol

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Clinical, radiographic, and endoscopic features of medication-induced esophagitis (MIE) in 4 patients are described. When the clinical history and symptoms raise a high index of suspicion for MIE, a double-contrast esophagram or endoscopic examination should be performed. The proximal esophagus, particularly the aortic segment, and occasionally the distal esophagus are the sites most commonly affected by MIE. Superficial mucosal erosions, shallow ulcers, and subtle mucosal alterations can be demonstrated by double-contrast esophagrams if careful attention is paid during performance and interpretation of these studies in an appropriate clinical setting.

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Section: Discussionmentioning

confidence: 99%

Medication-induced esophagitis

Agha

Wilson

Nostrand

1986

Gastrointest Radiol

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“…Doxycycline 0.1 g, ferrosulfate 0.1 g, ferrosuccinate 0.075 g and the analgesic combination drug Doleron®, were found to have a pH less than 3 (3). Other authors have also reported on the acidity of a doxycycline solution as a plausible explanation for the tissue damage (1,12). Solutions of pH less than 1.6 produce esophagitis in the cat (13), whereas a pH less than 3 is considered to be corrosive in the human esophagus (2).…”

Section: Discussionmentioning

confidence: 99%

“…In one study 100 severe esophageal ulcerations and 14 high esophageal strictures were attributed to oral drugs in a population of 1 million people (4). In the literature, 80-90% of patients with drug-induced esophageal lesions revealed no history of previous swallowing difficulties (3,4,9,10,12,14,23).…”

Section: Introductionmentioning

confidence: 99%

Esophageal Lesions Caused by Orally Administered Drugs

Carlborg

Densert

1980

Eur Surg Res

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This article presents an experimental method using cats for investigation of the local ulcerogenic properties of oral drugs in the esophagus. 15 drugs in current clinical use were tested. The drugs were placed in esophagus and the animals were sacrificed after 5–8 h, 4–7 or 21 days. The esophagus was cut open, photographed macroscopically and sectioned for light microscopy. Several drugs, e.g. doxycycline, alprenolol, propranolol, ferrosuccinate, ferrosulfate, and emepronium bromide showed marked ulcerogenic properties, whereas indomethacin and betamethasone did not cause any lesions in the cat esophagus. The results seem to be in accordance with the local effect these same drugs exert on the human esophageal mucosa. In order to predict and prevent drug-induced esophageal lesions in man we suggest that oral drugs should be tested concerning their local ulcerogenic properties in the esophagus.

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“…Die Azidität der Tetrazykline ist ein anderer wesentlicher schädigender Aspekt [2]. Versuche mit Ratten zeigten, dass Doxycyclin im Stratum basale des Plattenepithels akkumuliert und schlieûlich zu einer Störung der Proteinsynthese und Zelldegeneration führt [7].…”

Section: Klinischer Untersuchungsbefundunclassified

Ulzeröse Ösophagitis - Komplikation einer Doxycyclintherapie

Kinzel¹,

Martin²,

Schulz³

2004

Endo heute

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Ein 16-jähriger Patient stellte sich in unserer Endoskopieabteilung wegen seit mehreren Tagen bestehender Dysphagie, Odynophagie und retrosternalen Schmerzen vor. Aufgrund der Beschwerden wurde durch die Hausärztin bereits mit einer Protonenpumpenblockertherapie begonnen (Nexium 40 mg pro Tag).Aus der Krankengeschichte war lediglich die medikamentöse Behandlung einer Akne mittels eines Doxycyclinpräparates (Clinofug D 50) erwähnenswert. Der Patient nahm das Medikament seit etwa 4 Wochen einmal täglich am Abend ein.Die übrige Anamnese war unauffällig. ZusammenfassungAufgrund retrosternaler Schmerzen, Dys-und Odynophagie wurde bei einem 16-jährigen Patienten, der bis auf eine Aknetherapie mit Doxycylin eine unauffällige Anamnese aufwies, eine Öso-phago-Gastro-Duodenoskopie durchgeführt. Im mittleren Öso-phagusdrittel stellte sich eine ca. 5 cm groûe, die halbe Zirkumferenz einnehmende Ulzeration dar. Drei Tage nach Absetzen der Doxycyclintherapie war der Patient beschwerdefrei, die Kontrollendoskopie nach vier Wochen war unauffällig. Medikamenteninduzierte Ösophagusläsionen sind seit über 30 Jahren bekannt, ca. 50 % werden durch Tetrazykline verursacht. Die genaue Pathogenese ist unklar ± bei dem wahrscheinlich multifaktoriellen Geschehen spielt ein verlängerter Kontakt der aziden Tetrazykline mit der Ösophagusschleimhaut (Einnahme spätabends mit geringen Mengen Flüssigkeit) eine entscheidende Rolle. Schlüsselwörter Ulzeröse Ösophagitis´TetrazyklintherapieAbstract Suffering from retrosternal pain, dys-and odynophagia a 16-yearold patient underwent a esophago-gastro-duodenoscopy. Besides a Doxycyline-therapy due to acne the medical history was uneventful. In the middle esophagus a 5 cm measuring ulcer comprising nearly half of the circumference was found. Three days after abandoning the therapy the patient had no complaints, a control endoscopy four weeks later revealed no pathological findings. Since over 30 years drug-induced esophageal injury is a wellknown phenomenon, approximately 50 % caused by tetracyclines. The exact pathogenesis is unknown. One etiological factor of the presumably multifactorial origin might be the extended contact of the acidic tetracycline to the esophageal mucosa due to uncorrect medication (taking at night with only a small amount of water).

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Das Tetracyclin-Ulkus der Speiseröhre

Cited by 28 publications

References 0 publications

Medication-induced esophagitis

Medication-induced esophagitis

Esophageal Lesions Caused by Orally Administered Drugs

Ulzeröse Ösophagitis - Komplikation einer Doxycyclintherapie

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