Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present a case of esophageal ulcerations caused by alendronate (Fosamax), a recently marketed medication. The patient presented with a chief complaint of retrosternal pain and severe odynophagia of 5 days duration. She was taking prednisone 10 mg and azathioprine 100 mg p.o. q.d. for systemic lupus erythematosus. To prevent osteoporosis, she was started on alendronate 10 mg q.d. 2 wk before her symptoms started. Endoscopy of the upper GI tract revealed two deep, large ulcers at the gastroesophageal junction. Multiple biopsy specimens revealed necroinflammatory debris and acute esophagitis. However, no organisms were identified, and the result of her HIV test (ELISA) was negative. Alendronate was discontinued, and her symptoms resolved completely in 1 wk. Follow-up endoscopy performed 4 wk later revealed complete healing of the ulcers.
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PMID:A new probable increasing cause of esophageal ulceration: alendronate. 912 31

A 90-year old woman attended a department of Oral and Maxillofacial Surgery with a tongue that had been painful for at least 3 months. Clinical examination revealed extensive bullous and ulcerative lesions located on the tongue, the oral vestibule and the buccal mucosa on both sides. A variety of diseases may be causative of ulcerative stomatitis: autoimmune diseases (like Pemphigus vulgaris, Erosive Lichen Planus, SLE or M. Crohn), or a viral, bacterial or mycotical infection, vitamin deficiency, a toxic reaction to medication or an immune deficiency. After an extensive, clinical examination, a definitive diagnosis still had not been achieved. The patient suffered from osteoporosis, for which she used alendronate (Fosamax). A study of the literature described a possible relationship between the occurrence of oral ulcers and the use of oral biphosphonates. Since a toxic reaction to alendronate was suspected, the use of Fosamax tablets was suspended. Three months later a complete recovery of the oral mucosa was observed.
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PMID:[A toxic reaction of the oral mucosa to alendronate (Fosamax)]. 2072 98