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Colitis associated with persistent drug-induced immune dysregulation
Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical pathology. Med Univ Graz, Austria.
Landeskrankenhaus Furstenfeld, Austria.
Hosp Bros St John God, Austria.
Med Univ Graz, Austria.
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2024 (English)In: Virchows Archiv, ISSN 0945-6317, E-ISSN 1432-2307, Vol. 485, no 6, p. 1151-1155Article in journal (Refereed) Published
Abstract [en]

Adverse drug reactions frequently involve the gastrointestinal tract. We present two cases of colitis that occurred months to years after chemotherapy and autologous stem cell transplantation for the treatment of lymphoma. Laboratory tests revealed altered immune status with decreased CD4/CD8 ratio and hypogammaglobinemia (in one patient). The patients had no history of inflammatory bowel disease or immunodeficiency. Biopsies showed chronic active colitis with crypt architectural distortion, erosions, and ulcers as well as pyloric gland metaplasia and loss of plasma cells (in one patient, respectively). Colitis appeared to be related to lymphoma therapy, but could not be attributed to a distinct drug or infectious agent, suggesting the concept of persistent immune dysregulation driving mucosal inflammation. Hence, we suggest “immune dysregulation-associated colitis” (ID-colitis) as an umbrella term for cases of chronic colitis, in which immune dysfunction is evident from blood samples or clinical information and inflammatory bowel disease has been ruled out.

Place, publisher, year, edition, pages
SPRINGER , 2024. Vol. 485, no 6, p. 1151-1155
Keywords [en]
Colitis, Drug induced, Histology, Immune dysregulation, Immune dysfunction, Stem cell transplantation
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-207188DOI: 10.1007/s00428-024-03878-6ISI: 001288056200001PubMedID: 39120656Scopus ID: 2-s2.0-85200953726OAI: oai:DiVA.org:liu-207188DiVA, id: diva2:1894948
Available from: 2024-09-04 Created: 2024-09-04 Last updated: 2025-06-27

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