title: Doxycycline-induced gastrointestinal injury.
abstract: Doxycycline-induced gastric injury is a rarely recognized adverse effect of a common medication. Only 2 cases have previously described the distinctive capillary degeneration identified in gastric mucosa. We expanded on this by describing additional involved sites, endoscopic findings, and patient characteristics. Gastrointestinal biopsy materials for cases indexed with the word doxycycline were retrieved and the histology reviewed. The medical record was used to obtain clinical details. Three cases with biopsy materials were identified from the search, and doxycycline ingestion was confirmed. All patients' gastric biopsies had small vessel injury with fibrinoid material around the vessel, and 1 patient had similar changes in the duodenum. Endoscopic findings included fundic and pyloric erosions and ulcers. One patient had a normal endoscopy on follow-up after drug cessation. Confirmation and increased understanding of this drug-specific injury pattern are important for patient management, as cessation appears to result in symptom improvement and healing.
authors.affiliation: Pathology, University of Utah School of Medicine and ARUP Laboratories, University of Utah Health Science Center, Huntsman Cancer Hospital, Salt Lake City, UT, USA, 84112. Electronic address: kajsa.affolter@hsc.utah.edu.
authors.forename: Kajsa
authors.initials: K
authors.lastname: Affolter
authors.affiliation: Pathology, University of Utah School of Medicine and ARUP Laboratories, ARUP Laboratories, Anatomic Pathology, Salt Lake City, UT, USA, 84108. Electronic address: wade.samowitz@aruplab.com.
authors.forename: Wade
authors.initials: W
authors.lastname: Samowitz
authors.affiliation: Internal Medicine, Division of Gastroenterology, University of Utah School of Medicine, University of Utah Health Sciences Center, Gastroenterology, Salt Lake City, UT, USA, 84132. Electronic address: Kathleen.boynton@hsc.utah.edu.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Boynton
authors.affiliation: Pathology, University of Utah School of Medicine and ARUP Laboratories, University of Utah Health Science Center, Huntsman Cancer Hospital, Salt Lake City, UT, USA, 84112. Electronic address: erinn.downs-kelly@path.utah.edu.
authors.forename: Erinn Downs
authors.initials: ED
authors.lastname: Kelly
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001706:Biopsy; D004318:Doxycycline / Q000009:adverse effects*; D004381:Duodenal Ulcer / Q000139:chemically induced* / Q000473:pathology; D004386:Duodenum / Q000187:drug effects* / Q000473:pathology; D016145:Endoscopy, Digestive System; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline
keywords: Adverse effect; Doxycycline; Drug effect; Side effect