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Phenotype of histologically suspected drug-induced colitis; results of a comparative, retrospective cohort study.
Scand J Gastroenterol 2019; 54(7):855-862SJ

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-2). 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.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH , Bochum , Germany.Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH , Bochum , Germany.Institute of Pathology, Ruhr-University , Bochum , Germany.Institute of Pathology, Ruhr-University , Bochum , Germany.Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH , Bochum , Germany. Department of Internal Medicine, University Hospital Knappschaftskrankenhaus , Bochum , Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31215277

Citation

Brechmann, Thorsten, et al. "Phenotype of Histologically Suspected Drug-induced Colitis; Results of a Comparative, Retrospective Cohort Study." Scandinavian Journal of Gastroenterology, vol. 54, no. 7, 2019, pp. 855-862.
Brechmann T, Günther K, Neid M, et al. Phenotype of histologically suspected drug-induced colitis; results of a comparative, retrospective cohort study. Scand J Gastroenterol. 2019;54(7):855-862.
Brechmann, T., Günther, K., Neid, M., Tannapfel, A., & Schmiegel, W. (2019). Phenotype of histologically suspected drug-induced colitis; results of a comparative, retrospective cohort study. Scandinavian Journal of Gastroenterology, 54(7), pp. 855-862. doi:10.1080/00365521.2019.1630674.
Brechmann T, et al. Phenotype of Histologically Suspected Drug-induced Colitis; Results of a Comparative, Retrospective Cohort Study. Scand J Gastroenterol. 2019;54(7):855-862. PubMed PMID: 31215277.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Phenotype of histologically suspected drug-induced colitis; results of a comparative, retrospective cohort study. AU - Brechmann,Thorsten, AU - Günther,Katharina, AU - Neid,Matthias, AU - Tannapfel,Andrea, AU - Schmiegel,Wolff, Y1 - 2019/06/19/ PY - 2019/6/20/pubmed PY - 2019/6/20/medline PY - 2019/6/20/entrez KW - Colonic toxicity KW - colonoscopy KW - drug-associated gastrointestinal disease KW - drug-induced colitis SP - 855 EP - 862 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 54 IS - 7 N2 - 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-2). 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. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/31215277/Phenotype_of_histologically_suspected_drug-induced_colitis L2 - http://www.tandfonline.com/doi/full/10.1080/00365521.2019.1630674 DB - PRIME DP - Unbound Medicine ER -