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Drug-Induced Colitis

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Colitis

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Abstract

Drug-induced injury of the gastrointestinal tract is a relatively frequent though usually underestimated event, whose pathogenesis is based on different mechanisms.

The term “drug-induced colitis” at present does not identify a “real” nosological entity, because usually the diagnosis of this condition is based on clinical and endoscopic features, in the absence of clear histopathological findings.

The clinical presentation can be classified into two forms: an acute pattern with either prominent ischemia, constipation, or acute diarrhea and a more chronic pattern with chronic diarrhea that appears a long time after the start of drug therapy.

The histological manifestations are different, ranging from inflammation to ischemia, ulceration, or strictures, in some cases mimicking other pathological entities with different etiology.

In particular, the morphological features can be classified into different patterns: the inflammatory pattern (including hemorrhagic and pseudomembranous colitis, “microscopic colitis,” ulcerative colitis-like pattern, and Crohn’s disease-like pattern), the ischemic pattern, and the group of specific patterns (such as fibrosing colonopathy, apoptotic colopathy, and “pseudomelanosis or melanosis or pseudolipofuscinosis coli”).

It is also important to remember that some drugs can induce duodenal villous blunting with consequently malabsorption.

Finally, the hemorrhagic manifestations of anticoagulants on the GI tract are analyzed.

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Authors and Affiliations

  1. Institute of Pathology, Spedali Civili Brescia, Brescia, Italy

    Vincenzo Villanacci MD & Marianna Salemme MD

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  1. Vincenzo Villanacci MD
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  2. Marianna Salemme MD
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Correspondence to Vincenzo Villanacci MD .

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Editors and Affiliations

  1. Department of pathology, KULeuven, Leuven, Belgium

    Karel Geboes

  2. Department of Pathology, University of Cagliari, Cagliari, Italy

    Sonia Nemolato

  3. Department of Pathology, University of Cagliari, Cagliari, Italy

    Maria Leo

  4. Department of Pathology, University of Cagliari, Cagliari, Italy

    Gavino Faa

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Villanacci, V., Salemme, M. (2014). Drug-Induced Colitis. In: Geboes, K., Nemolato, S., Leo, M., Faa, G. (eds) Colitis. Springer, Cham. https://doi.org/10.1007/978-3-319-08028-4_12

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