What do we know today about drug-induced microscopic colitis? A case of lymphocytic colitis on olmesartan.

IF 1.3 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI:10.51821/86.3.11361

A Djembissi Fotso, M Arvanitakis, M Salame, J Gallez, A Lakis

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Abstract

Microscopic colitis is part of the differential diagnosis of chronic watery diarrhea. Colonoscopy discloses a normal looking mucosa, therefore its diagnosis is based on histology of colonic biopsies. Two main phenotypes are distinguished: collagenous colitis and lymphocytic colitis. A third entity, incomplete microscopic colitis or unspecified microscopic colitis has been reported in the literature. It affects preferentially women over 60 years of age and its association with certain drugs is increasingly established. In case of suspected drug-induced microscopic colitis, identification of the responsible drug is a key to management. After discontinuation of the suspected drug, the gold standard of treatment is budesonide both for induction and for maintenance in case of clinical relapse, as is often the case after discontinuation. Therapy with immunomodulators, biologics, or surgery is reserved for refractory forms of microscopic colitis after multidisciplinary consultation. Through the clinical case of colitis on olmesartan, we will review the latest recommendations on drug-induced microscopic colitis.

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显微镜下结肠炎是鉴别诊断慢性水样腹泻的一部分。结肠镜检查显示粘膜外观正常，因此其诊断是基于结肠活检的组织学。有两种主要表型：胶原性结肠炎和淋巴细胞性结肠炎。第三种实体，不完全性显微镜下结肠炎或未指明的显微镜下结肠炎已在文献中报道。它优先影响60岁以上的女性，而且它与某些药物的联系越来越牢固。在疑似药物诱导的显微镜下结肠炎的情况下，确定责任药物是管理的关键。停用可疑药物后，治疗的金标准是布地奈德，用于诱导和在临床复发的情况下维持，停药后通常也是如此。免疫调节剂、生物制剂或手术治疗保留用于多学科会诊后的难治性显微镜下结肠炎。通过奥美沙坦治疗结肠炎的临床案例，我们将回顾药物诱导显微镜下结肠炎的最新建议。

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来源期刊

Acta gastro-enterologica Belgica Medicine-Gastroenterology

CiteScore

2.30

自引率

20.00%

发文量

期刊介绍： The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.