Abstract
A 79-year-old female was diagnosed as having pure red cell aplasia with hypogammaglobulinemia. Although anemia was improved by administration of glucocorticoid, white cell count decreased markedly to 700/mm3 with marked granulocytopenia. She complained of fever and epigastric pain. The first endoscopic examination revealed 3 ulcers in the stomach and multiple white plaques in the esophagus. Culture of the white plaque was positive for candida. Leukocytopenia improved gradually after stopping all drugs administered. Potassium chloride was given for hypokalemia induced by glucocorticoid. Two months later, she complained of dysphagia and the second endoscopic exami-nation showed a stricture with erosion in the middle of the esophagus. Intranuclear inclusion bodies were seen in the biopsied specimen from the erosion at the esophageal stricture. Although candida, potassium chloride and cytomegalovirus were suspected as causes of the stricture, potassium chloride was considered as the most probable agent, since it produces an esophageal ulcer followed by a stricture similar to that found in this patient.
