A Case of Alendronate - induced Gastric Ulcer

Kim, Byung Ho; Joung, Young Hee; Chang, Young Woon; Min, Sun Kee; Moon, Ju Young; Han, Yo Seb; Lee, Dong Keun; Dong, Seok Ho; Kim, Hyo Jong; Lee, Jung Il; Chang, Rin

Abstract

Alendronate (Fosamax), an aminobisphosphonate and a selective inhibitor of osteoclast-mediated bone resorption, is used to treat postmenopausal osteoporosis and Paget's disease. In recent years, reports of severe esophageal injury in patients who took alendronate have evoked attention to the irritant effects of this drug on the mucosa of the upper gastrointestinal tract. We present a case of gastric ulcer caused by alendronate. The patient chiefly complainted of epigastric pain during 14 days. She had taken mefenamic acid for pain control for 3 years and she took once-weekly 70 mg of alendronate for 2 weeks for treatment of osteoporosis before the symptom started. Upper gastrointestinal endoscopy revealed two active gastric ulcers in the low body. The results of rapid urease test (CLO test) and modified Giemsa test for the detection of Helicobacter pylori infection were negative. After withdrawal of alendronate, the symptom resolved completely in one week. Six weeks later, follow-up endoscopy showed complete healing of the ulcer.