Deaths of Two Patients Treated by Phenylbutazone

Benstead, J. G.

doi:10.1136/bmj.1.4812.711

Cited by 16 publications

(2 citation statements)

References 2 publications

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“…Phenylbutazone was introduced to clinical use in 1949, and promptly a number of case‐reports appeared of peptic ulcer with perforation or hemorrhage in patients taking this first of the non‐aspirin NSAIDs 33–37 . Similar reports began to appear soon after indomethacin became available 38 …”

Section: Nonsteroidal Anti‐inflammatory Drugsmentioning

confidence: 99%

The ulcer sleuths: The search for the cause of peptic ulcers

Yeomans

2011

J of Gastro and Hepatol

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The search for the cause or causes of peptic ulcers has been a long one. It was recognised as early as the 19th Century that damage to the stomach or duodenal bulb was likely to result if the resistance of their mucosae to luminal acid was for some reason impaired. An early theory suggested microscopic vascular occlusion leading to local infarction could be the initiating event but evidence was lacking. Excessive acid secretion is seen in some patients but not in many so is implausible as the main factor in most ulcers. Cigarette smoking is a risk factor and chronic life difficulties has been shown to sometimes play a part, but we would now think that they play only minor roles to possibly tip the balance when a major etiologic factor is already present. The overwhelming evidence now is that the major etiologic factors in chronic peptic ulcer are ingestion of nonsteroidal antiinflammatory drugs (NSAIDs) and infection with Helicobacter pylori. Understanding the mechanism of the first, and the discovery and demonstration of Koch's postulates for the second, have been instrumental in the award of two Nobel prizes.

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Section: Nonsteroidal Anti‐inflammatory Drugsmentioning

confidence: 99%

The ulcer sleuths: The search for the cause of peptic ulcers

Yeomans

2011

J of Gastro and Hepatol

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“…Corticosteroids may produce peptic ulcers (Sandweiss, 1954). Similarly, a risk of phenylbutazone is peptic ulceration (Raffensperger, 1953), which can be fatal from perforation (Shield et al, 1953;Beutler and Bergenstal, 1954) or from haemorrhage (Stephens et al, 1952;Benstead, 1953). Phenylbutazone has other complications, such as depression of the bone-marrow and agranulocytosis (Dilling, 1953;Leonard, 1953), skin rashes (Cudkowicz and Jacobs, 1953), stomatitis (Freeland et al, 1953); visceral lesions (MacCarthy and Jackson, 1955), and water retention (Wilkinson and Brown, 1953), which may precipitate cardiac failure in the elderly.…”

Section: Conclusion and Summarymentioning

confidence: 99%