1. Presented by Belur Bhagavan, M.D. and prepared by Angelique W. Levi, M.D.

A 55-year-old woman with a history of orthotopic lung transplantation due to pulmonary fibrosis secondary to scleroderma was on multiple medications, including Immuran, Prednisone, Prilosec, Bactrim, Lasix, Aspirin, folate, and ferrous sulfate, among others. During follow-up, she developed acute mid-abdominal pain, nausea, belching and episodes of emesis. Esophago-gastro-duodenoscopy was performed which showed acute esophagitis, gastritis and ulceration of the distal esophagus.

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