Esophageal mucosal lesion with low-dose aspirin and prasugrel mimics malignancy: a case report

World J Gastroenterol. 2011 Sep 21;17(35):4048-51. doi: 10.3748/wjg.v17.i35.4048.

Abstract

Dual antiplatelet therapy consisting of low-dose aspirin (LDA) and other antiplatelet medications is recommended in patients with coronary heart disease, but it may increase the risk of esophageal lesion and bleeding. We describe a case of esophageal mucosal lesion that was difficult to distinguish from malignancy in a patient with a history of ingesting LDA and prasugrel after implantation of a drug-eluting stent. Multiple auxiliary examinations were performed to make a definite diagnosis. The patient recovered completely after concomitant acid-suppressive therapy. Based on these findings, we strongly argue for the evaluation of the risk of gastrointestinal mucosal injury and hemorrhage if LDA therapy is required, and we stress the paramount importance of using drug combinations in individual patients.

Keywords: Drug-eluting stent; Esophageal injury; Gastrointestinal hemorrhage; Low-dose aspirin; Prasugrel.

Publication types

  • Case Reports

MeSH terms

  • Aspirin / adverse effects*
  • Diagnosis, Differential
  • Drug-Eluting Stents
  • Esophageal Neoplasms / diagnosis*
  • Esophagus / drug effects*
  • Esophagus / pathology*
  • Humans
  • Intestinal Mucosa / drug effects*
  • Intestinal Mucosa / pathology*
  • Male
  • Middle Aged
  • Piperazines / adverse effects*
  • Platelet Aggregation Inhibitors / adverse effects
  • Prasugrel Hydrochloride
  • Purinergic P2Y Receptor Antagonists / adverse effects
  • Thiophenes / adverse effects*

Substances

  • Piperazines
  • Platelet Aggregation Inhibitors
  • Purinergic P2Y Receptor Antagonists
  • Thiophenes
  • Prasugrel Hydrochloride
  • Aspirin