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

[MeSci]

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

 

[Inara]

That's very interesting!

 

[NelliePledge]

That's very interesting!

yes very interesting as these are the main drugs the NHS gives you if you get diagnosed with "CFS/ME"along with Amitryptiline

 

[Amw66]

yes very interesting as these are the main drugs the NHS gives you if you get diagnosed with "CFS/ME"along with Amitryptiline

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....

 

[NelliePledge]

IAPT is live already in a lot of places

 

[Dolphin]

Merged thread

https://link.springer.com/article/10.1007/s40278-018-50379-z

An 18-year-old girl developed severe eosinophilic colitis while receiving treatment with gabapentin and pregabalin.

The girl had a history of incapacitating postural orthostatic tachycardia syndrome, severe chronic fatigue syndrome/myalgic encephalopathy, chronic total body pain, joint hypermobility syndrome and recurrent urinary tract infections. She was hospitalised for enteral feeding and physical rehabilitation. On admission, her weight was 35.3kg and she was fed through a nasojejunal tube. Her weight loss was due to functional dysphagia, nausea and severe functional dyspepsia postprandial distress syndrome, which prevented her from eating normal-size meals. She was subsequently started on gabapentin due to severe musculoskeletal pain and hyperalgesia. Within 5 days, she...