Abstract
A case of drug-induced esophagitis caused by an ascorbic acid tablet is reported. To our knowledge, this is the first report of esophagitis induced by ascorbic acid tablet in Japan. The patient, a 45-year-old female, took a Vit. C tablet without water just before going to sleep. In the next morning, she came to us because of the onset of pharyngeal discomfort. At endoscopic examination, a circumferential and diffuse thin white coat was found 15cm long in the upper esophagus. Biopsy specimen taken from the lesion showed degeneration of squamous epithelial layer and edema suggested by spaces among cells. And micro-abscess was shown in the more degenerated lesion. She was treated with sodium alginate and her symptom disappeared 3 days later. 10 days later, no abnormal lesion was found by endoscopic examination. The size of Vit. C tablet in this case was 19.3 × 8.1 × 7.6 mm, the pH was 2.42 and the Vit. C content was 995.6 mg. We considered that the drug caused esophageal mucosal injury for its large size and very low pH in this case.
