North American Study for the Treatment of Recurrent Epistaxis with Doxycycline: The NOSTRIL trial

Doxycycline

Doxycycline is one of the prototypical agents causing upper digestive tract irritation in the form of pill esophagitis and gastritis. We describe a 64-year-old man with known reflux esophagitis who developed unusual dysphagia two weeks after starting doxycycline therapy. On endoscopy, a sloughing esophagitis was found demonstrating microscopic features of spongiotic esophagitis with distinct eosinophilic vascular degeneration involving the superficial capillaries. Although such eosinophilic vascular degeneration has been considered pathognomonic for doxycycline injury in the stomach and the duodenum, to our knowledge, it has not been described previously in the setting of esophageal injury related to doxycycline.

Doxycycline-induced spongiotic oesophagitis is associated with eosinophilic vascular degeneration.

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Doxycycline-induced spongiotic oesophagitis is associated with eosinophilic vascular degeneration.