The spectrum of drug-related colitides: Important entities, though frequently overlooked

BackgroundThere is at present a relative lack of knowledge concerning drug-related colitides, although these may be not infrequent entities in clinical practice.AimsTo assess the frequency and the clinical–pathological subtypes of drug-related colitides in a gastrointestinal pathology referral centre.MethodsAll charts of endoscopic biopsy samples referred for colitis in a eight-year period were reviewed. To be classified as drug related colitis, patients’ charts should report the use of any drug in a two month period before colonoscopy and no other obvious cases of colitis be present. For analysis, we considered only patients taking one drug in this period.ResultsWe found 122 cases of drug-related colitis out of 3877 charts reviewed (3% of the overall colitis group). These cases were represented by microscopic colitis (50%), eosinophil rich infiltrate of the left colon (34%), ischemic colitis (11%), pseudomembranous colitis (3%), apoptotic colopathy (2%). The drugs most frequently associated with these colitides were represented by non-steroidal anti-inflammatory drugs.ConclusionIt is important to raise awareness concerning drug-related colitides, to avoid diagnostic errors and provide a better therapeutic approach to patients with these conditions.