[Acute exacerbation of a chronic esophagitis].
METHODS
A 50-year-old woman presented with progressive dysphagia and chest pain. Clinical and laboratory findings revealed a moderate epigastric pain and moderately elevated D-dimers. She had previously been diagnosed with esophagitis. Current oral medication included risedonate and clindamycin.


METHODS
The electrocardiogram was appropriate for age, with a SIQIII-sign and sinus tachycardia. Echocardiography, abdominal sonography and chest X-ray were unremarkable. Gastroscopy demonstrated severe inflammatory lesions in the middle part of the esophagus. The biopsies revealed crystalline material microscopically.


METHODS
The findings supported the diagnosis of an acute exacerbation of a chronic risedronat-induced esophagitis caused by clindamycin. After discontinuing the oral medication and giving intermittent parenteral nutrition the lesions healed completely.


CONCLUSIONS
Drug-induced esophagitis is often not recognized. Because of the high number of patients on bisphosphonate medication, often in combination with other potentially ulcerogenic drugs, the differential diagnosis should include drug-induced esophagitis.
Winkler-Budenhofer
U C
UC
Medizinische Klinik I, Klinikum der Universität München - Campus Grosshadern.
Ihrler
S
S
Göke
B
B
Kolligs
F T
FT
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002981:Clindamycin / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004941:Esophagitis / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D012968:Etidronic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D010288:Parenteral Nutrition; D000068296:Risedronic Acid
D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D002981:Clindamycin; D000068296:Risedronic Acid; D012968:Etidronic Acid