Reactions 1383 - 7 Jan 2012

SAspirin/prasugrel

Oesophageal mucosal lesion: case reportA 58-year-old man developed an oesophageal mucosal

lesion during treatment with aspirin and prasugrel [Effient]after drug-eluting stent implantation due to chest pain.

The man was hospitalised in August 2010 with melenaand haematemesis. Approximately 1.5 months prior toadmission he had undergone percutaneous coronaryintervention and implantation of a drug-eluting stent, andhad started receiving aspirin 100mg once daily andprasugrel 10mg once daily [routes not stated]; he haddeveloped epigastric discomfort with severe chest pain onemonth later. Gastroendoscopy revealed oedematousoesophageal mucosa with blood clots with lesionsoccupying more than half of the mucosa from the 26–42cmlevel. Oesophageal candidiasis was suspected. Seven daysbefore admission, he had passed a dark, approximately250g stool after taking cathartics. Gastroendoscopyperformed 3 days later, revealed a slim ulcer from26 to 40cm. Pathology was suggestive of granulomagangraenescens. Investigations revealed an irregularoesophageal wall with stiff movement, and a malignanttumour could not be excluded. The day after theexamination, he felt nauseous and vomited dark bloodclots.

The man received proton pump inhibitors, after whichthere was no sign of active bleeding. One week later, repeatgastroendoscopy showed that the oesophageal mucosahad peeled off. After admission, his antiplatelet drugs hadbeen discontinued and his symptoms improved within7 days; he was discharged on day 7. Follow-up endoscopy2 months later showed that the oesophageal lesion hadcompletely healed.Ma G-F, et al. Esophageal mucosal lesion with low-dose aspirin and prasugrelmimics malignancy: A case report. World Journal of Gastroenterology 17:4048-4051, No. 35, 21 Sep 2011. Available from: URL: http://dx.doi.org/10.3748/wjg.v17.i35.4048 - China 803064582

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Reactions 7 Jan 2012 No. 13830114-9954/10/1383-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved