title: First report of drug-induced esophagitis by deferasirox.
abstract: Deferasirox is a new oral iron chelator used to treat transfusional iron overload. We describe a case of a 79-year-old man with myelodysplastic syndrome (MDS) who developed esophagitis induced by deferasirox. He repeatedly received multiple red blood cell transfusions after a diagnosis of MDS. Two years after starting red blood cell transfusions, he was diagnosed with iron overload, and was then started on deferasirox at 1 g/day with about 400 ml of water. He was admitted to our institution because he was unable to swallow his own saliva 1 month after starting deferasirox. Esophagogastroendoscopy revealed white-coated mucosa covering the entire esophagus. A component analysis of biopsy specimens using high-performance liquid chromatography identified deferasirox. Symptoms resolved within about 2 weeks after discontinuing deferasirox, and repeated endoscopy showed marked improvement of esophagitis after 1 month. Re-administration of deferasirox was not attempted. Unfortunately, the patient died due to pneumonia 6 months after administration of deferasirox was started. This is the first report of drug-induced esophagitis associated with deferasirox.
authors.affiliation: Department of Internal Medicine, Kisogawa Municipal Hospital, Aichi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Araki
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsurumi
authors.forename: Masami
authors.initials: M
authors.lastname: Oyama
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
mesh_terms: D001565:Benzoates / Q000009:adverse effects* / Q000627:therapeutic use; D000077588:Deferasirox; D004941:Esophagitis / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007502:Iron Chelating Agents / Q000009:adverse effects*; D019190:Iron Overload / Q000150:complications / Q000188:drug therapy; D008297:Male; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000628:therapy; D065227:Transfusion Reaction; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D000077588:Deferasirox