Vascular Injury Characterizes Doxycycline-induced Upper Gastrointestinal Tract Mucosal Injury

Am J Surg Pathol. 2017 Mar;41(3):374-381. doi: 10.1097/PAS.0000000000000792.

Abstract

Doxycycline is an oral tetracycline antibiotic that has been associated with upper gastrointestinal (GI) mucosal injury. Recently, characteristic vascular degeneration has been reported in the stomach and duodenum in patients with doxycycline-induced injury. Fourteen patients who underwent upper GI endoscopy for nonspecific symptoms and were found to have doxycycline-induced gastric and esophageal injury are described. Most patients showed characteristic vascular injury. A control group of gastric erosions and esophageal ulcers showed no cases with the characteristic vascular changes. Clinical, endoscopic, and pathologic features of doxycycline-induced upper GI tract injury are reviewed, with an emphasis on vascular injury.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / adverse effects*
  • Case-Control Studies
  • Doxycycline / adverse effects*
  • Duodenum / blood supply
  • Duodenum / diagnostic imaging
  • Duodenum / drug effects*
  • Duodenum / pathology
  • Endoscopy, Gastrointestinal
  • Female
  • Follow-Up Studies
  • Gastric Mucosa / blood supply
  • Gastric Mucosa / diagnostic imaging
  • Gastric Mucosa / drug effects*
  • Gastric Mucosa / pathology
  • Humans
  • Intestinal Mucosa / blood supply
  • Intestinal Mucosa / diagnostic imaging
  • Intestinal Mucosa / drug effects*
  • Intestinal Mucosa / pathology
  • Male
  • Middle Aged
  • Vascular Diseases / chemically induced*
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / pathology
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Doxycycline