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Medication-induced acute esophageal necrosis: a case report

Overview of attention for article published in Journal of Medical Case Reports, September 2016
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2 tweeters

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10 Dimensions

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16 Mendeley
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Title
Medication-induced acute esophageal necrosis: a case report
Published in
Journal of Medical Case Reports, September 2016
DOI 10.1186/s13256-016-1043-z
Pubmed ID
Authors

Lauri Pautola, Tapio Hakala

Abstract

Acute esophageal necrosis or Gurvits syndrome is a rare clinical condition characterized by necrotic esophageal mucosa with an abrupt end at the gastroesophageal junction. Its etiology is multifactorial, but mainly related to low-flow states. We describe a case in which a patient accidentally took the wrong medication, with clozapine and olanzapine most probably being the cause of his subsequent acute esophageal necrosis. This situation is, to the best of our knowledge, unprecedented in the medical literature. A 65-year-old Finnish male patient with schizoaffective disorder accidentally took another patient's medication, including clozapine 300 mg, olanzapine 30 mg, teofyllamine 200 mg, warfarin 5 mg, and potassium chloride 1 g. He arrived at our hospital for a routine examination 6 h after the incident. At hospital he started to vomit brownish liquid and had tachycardia and fever. Gastroparesis was found. An endoscopy revealed necrotic esophageal mucosa that was typical for Gurvits syndrome. A computed tomography scan showed an edematous esophagus and raised suspicion of a proximal jejunal obstruction. A laparotomy was performed but only healthy paralytic bowel was found. Our patient healed uneventfully within a week. There are analogous case reports describing ischemic colitis associated with the use of clozapine and olanzapine, but none describing the same for the other medications our patient took. We believe that in this case clozapine and olanzapine caused acute esophageal necrosis and this possibility should be taken into account when treating patients with acute ischemic enteropathy.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 16 100%

Demographic breakdown

Readers by professional status Count As %
Other 4 25%
Student > Master 3 19%
Student > Doctoral Student 2 13%
Researcher 2 13%
Student > Ph. D. Student 1 6%
Other 2 13%
Unknown 2 13%
Readers by discipline Count As %
Medicine and Dentistry 9 56%
Chemistry 1 6%
Pharmacology, Toxicology and Pharmaceutical Science 1 6%
Unknown 5 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 April 2020.
All research outputs
#10,878,932
of 17,436,984 outputs
Outputs from Journal of Medical Case Reports
#885
of 2,901 outputs
Outputs of similar age
#149,924
of 276,948 outputs
Outputs of similar age from Journal of Medical Case Reports
#1
of 1 outputs
Altmetric has tracked 17,436,984 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,901 research outputs from this source. They receive a mean Attention Score of 3.0. This one has gotten more attention than average, scoring higher than 65% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 276,948 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 42nd percentile – i.e., 42% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them