title: [Duodenal ulcers caused by chloroquine-proguanil association].
abstract: Chloroquine-proguanil association is recommended for prophylaxis against falciparum malaria in countries with a low prevalence of chloroquine resistance. It is usually well tolerated with mild side effects consisting mainly of transient digestive discomfort and buccal manifestations (mouth sores or ulcers). The purpose of this report is to describe a case of duodenal ulcers presenting as epigastric pain with 10-kg weight-loss in a 32-year-old man taking chloroquine-proguanil for malaria prophylaxis during a stay in Haiti. No other causes of duodenal ulcers or weight-loss were found. Chloroquine-proguanil prophylaxis was discontinued and replaced by omeprazole for four weeks. Symptoms improved quickly and full recovery was observed within one month. To our knowledge, the occurrence of duodenal ulcers under chloroquine-proguanil association is quite rare, but possibly severe. Upper digestive endoscopy should be performed if a patient under chloroquine-proguanil develops abdominal pain especially in association with weight-loss. If endoscopy reveals duodenal ulcers, chloroquine-proguanil should be discontinued and replaced by another prophylactic regimen.
authors.affiliation: Service des maladies infectieuses et tropicales, Hôpital d'instruction des armées Bégin, Saint-Mandé, France. xavier.roux1@hotmail.fr
authors.forename: X
authors.initials: X
authors.lastname: Roux
authors.forename: P
authors.initials: P
authors.lastname: Imbert
authors.forename: F
authors.initials: F
authors.lastname: Rivière
authors.forename: F
authors.initials: F
authors.lastname: Méchaï
authors.forename: C
authors.initials: C
authors.lastname: Rapp
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage / Q000009:adverse effects*; D018890:Chemoprevention; D002738:Chloroquine / Q000008:administration & dosage / Q000009:adverse effects*; D004338:Drug Combinations; D004381:Duodenal Ulcer / Q000139:chemically induced*; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D002727:Proguanil / Q000008:administration & dosage / Q000009:adverse effects*; D014195:Travel
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D002738:Chloroquine; D002727:Proguanil