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Eosinophilic colitis caused by neuropathic agents in a patient with CFS (2018) Fragkos et al.

Discussion in 'Gastrointestinal and Urinary' started by MeSci, Jun 12, 2018.

  1. MeSci

    MeSci Senior Member (Voting Rights)

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    Source: Zeitschrift fur Gastroenterologie

    Vol 56, #6, pp 573-577

    Date: June 2018

    URL:
    https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-0596-7981

    Severe eosinophilic colitis caused by neuropathic agents in a patient with chronic fatigue syndrome and functional abdominal pain: Case report and review of the literature
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    Konstantinos C. Fragkos(1), John Barragry(1), Charisma Shahi Fernando(2), Marco Novelli(2), Joanna Begent(3), Natalia Zarate-Lopez(1)

    1 GI Physiology Unit, Department of Gastroenterology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

    2 Histopathology Department, University College London Hospitals NHS Foundation Trust, London United Kingdom.

    3 Adolescent Unit, University College London Hospitals NHS Foundation Trust, London United Kingdom.

    Abstract

    Eosinophilic colitis is a rare clinical condition that belongs to the group of eosinophilic gastrointestinal disorders. Its occurrence can be primary or secondary to infection, medications, or autoimmune/hematological conditions. We present a case of a young female adult with severe chronic fatigue syndrome, widespread chronic pain, including functional abdominal pain, who developed severe eosinophilic colitis following successive treatments with gabapentin and pregabalin. On both occasions, symptoms manifested as abdominal pain, diarrhea, and eosinophilia and improved upon discontinuation of the medications.

    Magnetic resonance imaging of the small bowel demonstrated an ascending colon colitis, and endoscopic investigations confirmed florid colitis mainly in the ascending colon with biopsies demonstrating a dense eosinophilic infiltrate with micro-abscesses. Serum eosinophil counts correlated well with the timing of the agents' administration. There was no other organ involvement. Symptoms improved upon discontinuation of the drugs and steroid administration. Eosinophilic colitis is an exceptionally rare entity and its mechanism of action is still unclear.

    Suspicion of eosinophilic colitis should be raised if a patient presents with abdominal pain, diarrhea, and peripheral eosinophilia following treatment with pregabalin or gabapentin.

    Key words: gabapentin - pregabalin - eosinophilic colitis - myalgic encephalopathy - functional bowel disorder

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    (c) 2018 Georg Thieme Verlag KG
     
    Hutan, Forbin, alktipping and 8 others like this.
  2. Inara

    Inara Senior Member (Voting Rights)

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    That's very interesting!
     
    Samuel and MeSci like this.
  3. NelliePledge

    NelliePledge Senior Member (Voting Rights)

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    yes very interesting as these are the main drugs the NHS gives you if you get diagnosed with "CFS/ME"along with Amitryptiline
     
    alktipping and Inara like this.
  4. Amw66

    Amw66 Senior Member (Voting Rights)

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    I do wonder that

    If this person had not been in London ( assumption due to hospital details) and/ or

    If this was to happen in a couple of years time with IAPT roll out / MUS agenda/ IBD and SNOWMED codings

    Just how seriously this would have been investigated....
     
    JemPD, Hutan, Arnie Pye and 1 other person like this.
  5. NelliePledge

    NelliePledge Senior Member (Voting Rights)

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    IAPT is live already in a lot of places
     

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