doxycycline hydrochloride tabletによる急性食道潰瘍の2例

Acute Esophageal Ulcers Associated with Doxycycline Therapy, Report of Two Cases

要旨〔症例1〕17歳，女性．1983年2月16日，就眠前にdoxycycline 1錠を水なしで服用．翌朝より前胸部痛が出現．食道内視鏡検査にて切歯より30cmの食道に不整形の潰瘍を1個認めた．第30病日には潰瘍は治癒していた．〔症例2〕52歳，男性．1983年10月28日，就眠前にdoxycycline 1錠を少量の水で服用．夜間に前胸部痛出現．食道内視鏡検査にて切歯より28～30cmの食道に円形の浅い潰瘍を3個認めた．第10病日には潰瘍は治癒していた．1個の錠剤の服用によって多発性潰瘍ができるのは，就眠中の体位の変換，食道の蠕動などに伴う薬剤の移動によると考えられた．本邦報告例17例を集計し，自験2例を加えた19例について若干の検討を行った．

　Two cases of doxycydine tablet-induced esophageal ulcer are presented with special reference to their endoscopic characteristics. As to the patient's history, it was very characteristic that they took a tablet just before lying in bed, with no or only small amount of water. Clinical symptom was dysphagia and the symptom appeared soon after taking the drug. The diagnosis was fairly easy because of the characteristic history and the relationship to the drug.

　Endoscopic examination confirmed fresh ulcers in two cases. In the first case, taking a doxycycline tablet caused a single ulcer with the edematous margin, irregular in shape, and in the second case, a doxycycline tablet caused multiple ulcers, round in shape. This discrepancy might be closely related to the lodging time of a tablet to the esophageal mucosa.