Endoscopy 2001; 33(7): 629-632
DOI: 10.1055/s-2001-15315
Case Report

© Georg Thieme Verlag Stuttgart · New York

Nonsteroidal Anti-Inflammatory Drug-Associated Colitis with a Histology of Collagenous Colitis

K. Yagi1 , A. Nakamura1 , A. Sekine1 , H. Watanabe2
  • 1 Dept. of Internal Medicine, Niigata Prefectural Yoshida Hospital, Yoshidamachi, Niigata, Japan
  • 2 First Dept. of Pathology, Niigata University School of Medicine, Asahimachi, Niigata, Japan
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Here we report a case of nonsteroidal anti-inflammatory drug (NSAID)-associated colitis with a histology of collagenous colitis in a 77-year-old woman. The patient had taken aspirin since 1993 after being diagnosed at another hospital, as having multiple cerebral infarctions. She began to suffer from intermittent diarrhea in April 1999. Serological examination showed hypoproteinemia, which indicated that she had protein-losing enteropathy. By July 1999, she had undergone colonoscopic examination four times. Biopsy specimens taken during the fourth colonoscopy revealed collagenous colitis. As the patient had been taking aspirin for 6 years, she was diagnosed as having NSAID-associated colitis with a histology of collagenous colitis. When she stopped taking aspirin, the diarrhea ceased. Three months later, the patient underwent a fifth colonoscopy. A histological examination of the biopsy specimen revealed that the collagen band had vanished. NSAID-associated colitis sometimes shows collagenous colitis histologically and is cured by withdrawing the drug. It is important to differentiate NSAID-associated colitis, even if it shows a histology of collagenous colitis, from collagenous colitis as the two diseases differ in etiology and therapy.

References

  • 1 Lindstrom C G. ”Collagepous colitis” with watery diarrhea. A new entity?.  Pathol Eur. 1976;  11 87-89
  • 2 Giardiello F M, Bayless T M, Jessurun J, et al. Collagenous colitis: physiological and histopathological studies in seven patients.  Ann Intern Med. 1987;  106 46-49
  • 3 Lewin K J, Riddell R H, Weinstein W M. Gastrointestinal pathology and its clinical implications.  New York; Igaku-Shoin 1992: 1092-1094
  • 4 Giardiello F M, Hansen F C, Lazenby AJ, et al. Collagenous colitis in setting of nonsteroidal antiinflammatory drugs and antibiotics.  Dig Dis Sci. 1990;  35 257-260
  • 5 Riddell R H, Tanaka M, Mazzoleni G. Non-steroidal anti-inflammatory drugs as a possible cause of collagenous colitis: a case-control study.  Gut. 1992;  33 683-686
  • 6 Katanuma A, Kodama T, Tamaki T, et al. Collagenous colitis.  Intern Med. 1995;  34 195-198
  • 7 Bohr J, Tysk C, Eriksson S, et al. Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients.  Gut. 1996;  39 846-851
  • 8 Baert F, Wouters K, D'Haens G, et al. Lymphocytic colitis: a distinct clinical entity? A clinicopathological confrontation of lymphocytic and collagenous colitis.  Gut. 1999;  45 375-381
  • 9 Carratu R, Parisi P, Agozzino A. Segmental ischemic colitis associated with nonsteroidal antiinflammatory drugs.  J Clin Gastroenterol. 1993;  16 31-34
  • 10 Davies N M. Toxicity of nonsteroidal anti-inflammatory drugs in the large intestine.  Dis Colon Rectum. 1995;  38 1311-1321
  • 11 Goldstein N S, Cinenza A N. The histopathology of nonsteroidal anti-inflammatory drug-associated colitis.  Am J Clin Pathol. 1998;  110 622-628
  • 12 Bjarnason I, Hayllar J, Macpherson A J, et al. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans.  Gastroenterology. 1993;  104 1832-1947

 K. Yagi, M.D.

Dept. of Internal Medicine
Niigata Prefectural Yoshida Hospital

Yoshidamachi
Nishikanbaragun
Niigataken 959-0242
Japan


Fax: Fax:+ 81-256-922610

Email: E-mail:yagikazu@popl2.odn.ne.jp

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