Doxycycline-induced gastrointestinal injury

Hum Pathol. 2017 Aug:66:212-215. doi: 10.1016/j.humpath.2017.02.011. Epub 2017 Mar 9.

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.

Keywords: Adverse effect; Doxycycline; Drug effect; Side effect.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects*
  • Biopsy
  • Doxycycline / adverse effects*
  • Duodenal Ulcer / chemically induced*
  • Duodenal Ulcer / pathology
  • Duodenum / drug effects*
  • Duodenum / pathology
  • Endoscopy, Digestive System
  • Female
  • Gastric Mucosa / drug effects*
  • Gastric Mucosa / pathology
  • Humans
  • Intestinal Mucosa / drug effects*
  • Intestinal Mucosa / pathology
  • Male
  • Middle Aged
  • Stomach Ulcer / chemically induced*
  • Stomach Ulcer / pathology

Substances

  • Anti-Bacterial Agents
  • Doxycycline