Centro Médico ABC, Ciudad de México, México.
Bol Med Hosp Infant Mex. 2020;77(1):38-41. doi: 10.24875/BMHIM.19000109.
Drug-induced esophagitis is an uncommon diagnosis in the pediatric population. The following is a report of six adolescents with L-arginine-induced esophagitis.
All patients were under treatment with L-arginine for short stature. After using the prescribed medication for 1-3 months, all cases started with severe retrosternal pain, odynophagia, and dysphagia. The upper gastrointestinal endoscopies showed ulcers located in the mid esophageal mucosa.
In the presence of acute severe odynophagia, dysphagia, and retrosternal pain, drug-induced esophagitis should be considered as a possible diagnosis. Treatment includes liquid diet, pain control, sucralfate, omeprazole, and interruption of L-arginine. In addition, the physician should explain preventive measures focused on patient and family education on the drug side effects and precise instructions on how to take medications, as well as a careful balance of risk and benefits of any medication. At present, there are no clinical trials that support the use of L-arginine in treatment of short stature.
药物性食管炎在儿科人群中并不常见。以下是 6 例精氨酸诱导性食管炎的报告。
所有患者均因身材矮小而接受精氨酸治疗。在使用规定的药物治疗 1-3 个月后，所有患者均开始出现严重胸骨后疼痛、吞咽困难和吞咽痛。上消化道内镜检查显示食管中段黏膜溃疡。
在出现急性严重吞咽痛、吞咽困难和胸骨后疼痛时，应考虑药物性食管炎作为可能的诊断。治疗包括液体饮食、止痛、硫糖铝、奥美拉唑和精氨酸中断。此外，医生应向患者和家属解释药物副作用的预防措施，并就如何服药进行详细说明，以及仔细权衡任何药物的风险和益处。目前，没有临床试验支持使用精氨酸治疗身材矮小。
