scholarly journals Lymphocytic colitis: a distinct clinical entity? A clinicopathological confrontation of lymphocytic and collagenous colitis

Gut ◽  
1999 ◽  
Vol 45 (3) ◽  
pp. 375-381 ◽  
Author(s):  
F Baert ◽  
K Wouters ◽  
G D’Haens ◽  
P Hoang ◽  
S Naegels ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Clinical Features ◽  
Collagenous Colitis ◽  
Lymphocytic Colitis ◽  
Histological Findings ◽  
Drug Induced ◽  
Duration Of Symptoms ◽  
Histological Features ◽  
Autoimmune Conditions ◽  
Inflammatory Drugs

BACKGROUND AND AIMSIt is not known whether lymphocytic colitis and collagenous colitis represent different clinical entities or constitute part of a spectrum of disease.METHODSDetailed clinical features and histological findings were compared in a large series of patients with confirmed lymphocytic and collagenous colitis.RESULTSHistological diagnosis was confirmed in 96 patients with collagenous colitis and 80 with lymphocytic colitis. Twenty eight per cent of patients with collagenous colitis and 26% of patients with lymphocytic colitis had overlapping but less pronounced histological features. Both groups were equal in terms of age, use of aspirin and non-steroidal anti-inflammatory drugs, associated autoimmune conditions, arthritis, diarrhoea, and abdominal pain. The male:female ratio was 27:73 for collagenous colitis and 45:55 for lymphocytic colitis (p=0.013). Twenty five per cent of patients with collagenous colitis compared with 14% of patients with lymphocytic colitis were active smokers; only 8.3% of patients with collagenous colitis had stopped smoking compared with 23% of patients with lymphocytic colitis (p=0.013). Drug induced disease was suspected for ticlopidine (two collagenous colitis, four lymphocytic colitis) and flutamide (four lymphocytic colitis). Mean duration of symptoms before diagnosis was two months for lymphocytic colitis and four months for collagenous colitis. Overall prognosis was generally mild; 84% of patients with lymphocytic colitis and 74% of patients with collagenous colitis reported resolution or significant improvement (p=0.033).CONCLUSIONSCollagenous and lymphocytic colitis are similar but not identical. Patients with lymphocytic colitis present somewhat earlier and are less likely to be active smokers. Symptoms are milder and more likely to disappear in lymphocytic colitis. Ticlopidine and flutamide should be added to the list of drugs inducing colitis.

Role of bile acid malabsorption and clinical features in lymphocytic colitis. A comparison with collagenous colitis

2000 ◽  
Vol 118 (4) ◽  
pp. A884 ◽  
Author(s):  
Kjell-Arne Ung ◽  
Anders Kilander ◽  
Roger Willen ◽  
Hasse Abrahamsson
Keyword(s):  
Bile Acid ◽  
Clinical Features ◽  
Collagenous Colitis ◽  
Lymphocytic Colitis ◽  
Bile Acid Malabsorption

scholarly journals Resolution of Multiple Severe Nonsteroidal Anti-Inflammatory Drug-Induced Colonic Strictures with Prednisone Therapy: A Case Report and Review of the Literature

2003 ◽  
Vol 17 (8) ◽  
pp. 497-500 ◽  
Author(s):  
Robert M Penner ◽  
C Noel Williams
Keyword(s):  
Abdominal Pain ◽  
Complete Resolution ◽  
Nsaid Therapy ◽  
University Hospital ◽  
Review Of The Literature ◽  
Drug Induced ◽  
First Case ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Colonic Strictures

A 69-year-old woman on nonsteroidal anti-inflammatory drugs (NSAIDs) was admitted to a university hospital with abdominal pain, profound anemia and melena stools. Duodenal ulceration and subsequent healing were documented. Colonoscopy revealed haustral ulceration and NSAID-induced colonic diaphragm disease. Discontinuation of NSAID therapy did not result in endoscopic change, but a 20-week course of prednisone was followed by complete resolution. This is the first case describing prednisone monotherapy for such strictures, and only the second in which endoscopic resolution has been documented. With further supporting experience, prednisone may be considered in addition to NSAID discontinuation for patients with this rare but serious complication.

Sa1017 A COMPARISON OF LYMPHOCYTIC COLITIS AND COLLAGENOUS COLITIS

2020 ◽  
Vol 158 (6) ◽  
pp. S-243-S-244
Author(s):  
Syed Bilal Pasha ◽  
Samantha Dyroff ◽  
Tao Zhang ◽  
Henok Woldu ◽  
Deepthi S. Rao ◽  
...  
Keyword(s):  
Collagenous Colitis ◽  
Lymphocytic Colitis

scholarly journals Ibuprofen-Induced Aseptic Meningitis in a Male Adolescent with Intracranial Hypertension and Visual Impairment: A Case Report

2021 ◽  
Vol 13 (1) ◽  
pp. 233-238
Author(s):  
Seyed Mohammad Mousavi Mirzaei ◽  
Zahra Ahmadi
Keyword(s):  
Visual Impairment ◽  
Intracranial Hypertension ◽  
Aseptic Meningitis ◽  
Rare Complication ◽  
Clinical Signs ◽  
Male Adolescent ◽  
Drug Induced ◽  
Blurred Vision ◽  
Inflammatory Drugs

Drug-induced aseptic meningitis (DIAM) is a rare complication of certain drugs, most commonly reported with ibuprofen use. The present study reports on a male adolescent with intracranial hypertension and visual impairment accompanied by DIAM. We present a 16-year-old male patient who after ibuprofen consumption displayed headache, fever, photophobia, and blurred vision following heavy exercises. Examination of cerebrospinal fluid showed a mononuclear pleocytosis and an increase in protein concentration. Other examinations had normal results. The development of common clinical signs following ibuprofen use reflected DIAM. The patient’s vision was found to improve with supportive care and stopping of the drug during follow-up. Given the widespread use of nonsteroidal anti-inflammatory drugs and the fact that these drugs are the most common cause of DIAM, the probability of occurrence of this event should be always kept in mind, and screening for autoimmune diseases in these patients is of great importance.

scholarly journals AB0327 DRUG-INDUCED LUPUS ERYTHEMATOSUS SECONDARY TO ANTI-TNF-Α AGENTS IN PATIENTS WITH SPONDYLOARTHRITIS AND PSORIATIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1188.2-1189
Author(s):  
A. Martins ◽  
D. Santos Oliveira ◽  
F. R. Martins ◽  
M. Rato ◽  
F. Oliveira Pinheiro ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Clinical Features ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Age At Diagnosis ◽  
Categorical Variables ◽  
Drug Induced ◽  
Laboratory Findings ◽  
Conversion Rates ◽  
Tnf Α

Background:Induction of autoantibodies is frequently observed in patients treated with TNF-α antagonist and the possible development of drug-induced lupus erythematosus (DILE) remains a matter of concern. The prevalence of DILE secondary to anti-TNF-α therapy is estimated around 0.5-1% and clinical features include arthritis/arthralgia, rash, serositis, fever, myalgias, cytopenias, among others. According to the literature, DILE secondary to anti-TNF-α agents differs in several ways from the clinical and laboratory findings typically associated with classic DILE.Objectives:To estimate the incidence of induction of antinuclear antibodies (ANA) and DILE in a monocentric cohort of patients with spondyloarthritis and psoriatic arthritis treated with anti-TNF-α agents. To describe the clinical and laboratorial features and outcomes of patients with DILE.Methods:We performed a retrospective analysis of patients with spondyloarthritis and psoriatic arthritis treated with anti-TNF-α agents, from our University Hospital, who have been registered on the Portuguese Rheumatic Diseases Register (Reuma.pt) between July 2001 and December 2020. Patients with positive ANA (titer > 1/100) before the anti-TNF-α therapy were excluded. Because specific criteria for the diagnosis of DILE have not been established, we considered the diagnosis in case of a temporal relationship between clinical manifestations and anti-TNF-α treatment and fulfillment of ACR/EULAR 2019 classification criteria for SLE. In patients with DILE, clinical features, laboratory findings, systemic therapies and outcome after discontinuation of medication were collected from reuma.pt and medical records. For the clinical and demographic predictors, continuous variables were analyzed using a two-sided t-test and categorical variables using a Fisher’s exact test. P-value <0.05 was considered statistically significant.Results:In the spondyloarthritis group, 290 patients were included (44.8% females, mean age at diagnosis of 33.3 ± 11.5 years and mean disease duration of 15.1 ± 10.4 years) and in the psoriatic arthritis group, 116 patients were included (50.0% females, mean age at diagnosis of 40.1 ± 11.0 years and mean disease duration of 13.1 ± 6.8 years). In our study, we observed high serology conversion rates (positive ANA in 67.9% and 58.6% of patients with Spondyloarthritis and Psoriatic Arthritis, respectively), with similar conversion rates between different anti-TNF drugs. Three patients with spondyloarthritis (1.0%) and 1 patient with psoriatic arthritis (0.9%) developed DILE. Etanercept was the causative agent in 2 cases, infliximab and adalimumab in 1 case, each. Peripheral arthritis (new onset or abrupt worsening) occurred in 2 patients, serositis in 1 patient, constitutional symptoms in 2 patients, subnephrotic proteinuria in 1 patient, lymphopenia in 2 patients and hypocomplementemia in 1 patient. Specific treatment was prescribed to the 4 patients (oral corticosteroids) and they achieved complete recovery. After anti–TNF-α treatment interruption, no patient had recurrent disease. We observed that patients with DILE had a significantly longer disease duration (> 8.4 years; p=0.04) and a significantly longer duration of therapy with anti-TNF (> 4.0 years; p=0.04) when compared to patients without DILE.Conclusion:Despite the frequent induction of autoantibodies, the development of DILE secondary to anti–TNF-α agents is rare. Our study demonstrates an incidence rate similar to other studies reported before. The clinical and laboratorial characteristics of our patients with DILE attributable to anti–TNF-α agents differ significantly from DILE due to more traditional agents, as is described in literature. Overall, patients in this study had mild disease that improved after therapy discontinuation, without recurrence of the disease. It seems that a longer disease duration and a longer period under anti-TNF-α therapy may increase the risk of DILE development.Disclosure of Interests:None declared

scholarly journals Spontaneous Perinephric Urinoma Secondary to Drug Induced Acute Interstitial Nephritis: A Case Report

2021 ◽  
Author(s):  
Rajesh Kumar Varatharajaperumal ◽  
Rupa Renganathan ◽  
V Mangalakumar ◽  
Sriman Rajasekaran ◽  
Venkatesh Kasi Arunachalam
Keyword(s):  
Abdominal Pain ◽  
Interstitial Nephritis ◽  
Lower Abdominal Pain ◽  
Acute Interstitial Nephritis ◽  
Computed Tomography Scan ◽  
Drug Induced ◽  
Significant Deterioration ◽  
Loin Pain ◽  
Tomography Scan ◽  
Collecting System

AbstractUrinoma is defined as the extravasation of urine from any part of the urinary collecting system, which causes lipolysis of the surrounding fat, resulting in an encapsulated collection. The most common cause of urinoma is the direct obstruction of the urinary system. The other etiologies include trauma and postinstrumentation/surgery. Parenchymal cause for spontaneous urinoma is exceedingly rare. We present a case of a 30-year-old gentleman who presented with lower abdominal pain and was treated with a Diclofenac injection. The pain got better temporarily, but he presented again with right loin pain after 3 days. His computed tomography scan images revealed bilateral perinephric urinoma. As there was significant deterioration of renal function, he underwent a renal biopsy. The histopathology was reported as acute interstitial nephritis (AIN). Drug-induced AIN is very rarely presented with acute loin or abdominal pain due to spontaneous perinephric urinoma, as it was seen in our case.

scholarly journals Acute generalized exanthematous pustulosis (AGEP). Case report

2005 ◽  
Vol 47 (3) ◽  
pp. 171-176 ◽  
Author(s):  
Walter Belda Junior ◽  
Ana Carolina Junqueira Ferolla
Keyword(s):  
Antidepressant Drugs ◽  
Corticosteroid Treatment ◽  
Beta Lactam ◽  
Drug Induced ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Outpatient Unit ◽  
Similar Drug ◽  
Generalized Pustular Psoriasis ◽  
Inflammatory Drugs ◽  
Exanthematous Pustulosis

Acute Generalized Exanthematous Pustulosis (AGEP) is a drug-induced dermatosis characterized by an acute episode of sterile pustules over erythematous-edematous skin. It is accompanied by an episode of fever, which regresses a few days after discontinuation of the drug that caused the condition or as a result of corticosteroid treatment. The main triggering drugs are antibiotics, mainly beta-lactam ones. Other medications, such as antifungal agents, non steroid anti-inflammatory drugs, analgesics, antiarrhythmic, anticonvulsant and antidepressant drugs, may also be responsible. Histologically, it is characterized by the existence of vasculitis, associated with non-follicular subcorneal pustules. A case of a Caucasian female outpatient unit of Dermatology with AGEP, who presented with generalized pustulosis lesions after the use of cephalosporin for urinary infection is related. The diagnosis was confirmed by the clinical and pathological correlations, the resolution of the dermatosis after discontinuation of the drug and use of systemic corticosteroid treatment, and the recurrence of the disorder after the introduction of a similar drug. The importance of the recognition of this drug-induced dermatosis is given by its main differential clinical and histological diagnoses: generalized pustular psoriasis and subcorneal pustulosis.

scholarly journals Familial Microscopic Colitis

2001 ◽  
Vol 15 (5) ◽  
pp. 341-343 ◽  
Author(s):  
Ayman Assad Abdo ◽  
Peter Jeffrey Zetler ◽  
Lawrence S Halparin
Keyword(s):  
Chronic Diarrhea ◽  
Present Report ◽  
Disease Process ◽  
Collagenous Colitis ◽  
Microscopic Colitis ◽  
Familial Occurrence ◽  
Lymphocytic Colitis ◽  
The Third ◽  
Inflammatory Conditions ◽  
Colonic Biopsy

Collagenous and lymphocytic colitis are two inflammatory conditions of the colon that are often collectively referred to as microscopic colitis. The present report describes what is believed to be the third published case of familial microscopic colitis. A 55-year-old woman who suffered from chronic diarrhea was diagnosed with lymphocytic colitis on colonic biopsy. Subsequently, her 36-year-old daughter was diagnosed with collagenous colitis. The familial occurrence of these diseases may support an immunological hypothesis for their etiology. In addition, it supports the assumption that collagenous and lymphocytic colitis are two manifestations of the same disease process rather than two completely separate entities. The familial tendency of this disease may make a case for early colonoscopy and biopsy in relatives of patients diagnosed with microscopic colitis if they present with suggestive symptoms.

scholarly journals Prevalence of Celiac Disease in Collagenous and Lymphocytic Colitis

2000 ◽  
Vol 14 (11) ◽  
pp. 919-921 ◽  
Author(s):  
Helen Rachel Gillett ◽  
Hugh James Freeman
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Collagenous Colitis ◽  
Lymphocytic Colitis ◽  
Small Bowel Biopsy ◽  
Major Antigen ◽  
Immunofluorescent Technique ◽  
Endomysium Antibody

Both collagenous and lymphocytic colitis have been described in patients with celiac disease, suggesting an association between the conditions. Over the past few years, the availability, sensitivity and specificity of serological markers for celiac disease have improved - the most recent advancement being the description of tissue transglutaminase as the major antigen for endomysium antibody. A quantitative ELISA was used to measure titres of immunoglobulin A (IgA) antibody to tissue transglutaminase (tTG) along with an immunofluorescent technique for IgA endomysium antibody (EmA) in 15 patients with lymphocytic colitis and eight with collagenous colitis to determine whether celiac disease latency could be detected. One patient with lymphocytic colitis demonstrated both elevated titres of tTG antibody and positive EmA, and small bowel biopsy confirmed celiac disease. One patient with collagenous colitis had a slightly elevated titre of tTG antibody with a negative EmA, and results of a small bowel biopsy were normal. Three other patients with lymphocytic colitis were already treated for previously diagnosed celiac disease. The prevalence of celiac disease occurring in lymphocytic colitis was found to be 27%, but no cases of celiac disease in association with collagenous colitis were found.

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