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Phenotype of histologically suspected drug-induced colitis; results of a comparative, retrospective cohort study.
- Source :
-
Scandinavian journal of gastroenterology [Scand J Gastroenterol] 2019 Jul; Vol. 54 (7), pp. 855-862. Date of Electronic Publication: 2019 Jun 19. - Publication Year :
- 2019
-
Abstract
- Background/aims: Drug-induced colitis (DiC) is a rarely reported form of colonopathy and data about the clinical and endoscopic characteristics are scarce. The aim was to investigate the phenotype of DiC. Methods: Patients in a retrospective case control study were assigned to either DiC or one of two age- and gender-matched control groups (non-inflammatory controls and inflammatory colitis from other causes) based on histopathological findings. Patients' basic characteristics, symptoms, biochemical results and endoscopic appearance were collected. Statistical analysis included ANOVA, the chi-squared test and two-tailed t-test. Results: A total of 211 patients with DiC were included (97 males, age 62.1 ± 16.1 years, BMI 25.9 ± 6.1 kg m <superscript>-2</superscript> ). In comparison to both control groups, DiC patients presented higher ASA and ECOG-scores and more particularly atherosclerotic comorbidities. The most abundant symptoms were abdominal pain (51.8%), diarrhoea (50.7%) and haematochezia (24.3%). The red blood cell count demarcated anaemia (12.7 ± 2.3 mg/dl) and C-reactive protein was slightly elevated (2.7 ± 5.2 mg/dl). The endoscopic features included erythema (46.9%), oedema (29.9%), erosions (29.9%) and ulcers (14.7%). The inflammation affected the rectum rarely (2.4%) but affected the rest of the colon without predilection in a segmental manner ( p <.05). The severity of DiC was mostly mild (85.7%). Conclusions: The phenotype of DiC differs slightly from that of colitis from other causes. Taking the clinical features into account might help to confirm drug-induced aetiology once the pathologist has raised the suspicion.
- Subjects :
- Abdominal Pain etiology
Aged
Atherosclerosis drug therapy
Biopsy
C-Reactive Protein analysis
Colitis physiopathology
Colon drug effects
Colon pathology
Colonoscopy
Comorbidity
Diarrhea etiology
Female
Gastrointestinal Hemorrhage etiology
Germany
Humans
Intestinal Mucosa drug effects
Male
Middle Aged
Phenotype
Retrospective Studies
Anti-Inflammatory Agents, Non-Steroidal adverse effects
Colitis chemically induced
Colitis pathology
Intestinal Mucosa pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1502-7708
- Volume :
- 54
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Scandinavian journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 31215277
- Full Text :
- https://doi.org/10.1080/00365521.2019.1630674