pulmicort and Enterocolitis--Pseudomembranous

Topics: Age Factors; Aged; Aged, 80 and over; Anti-Infective Agents; Anti-Inflammatory Agents; Antidiarrheals; Budesonide; Cholestyramine Resin; Chronic Disease; Clostridioides difficile; Colitis, Microscopic; Diagnosis, Differential; Diarrhea; Enterocolitis, Pseudomembranous; Glucocorticoids; Humans; Intestinal Diseases; Irritable Bowel Syndrome; Medical History Taking; Metronidazole; Randomized Controlled Trials as Topic; Time Factors

George, a 55-year-old retired businessman with a diagnosis of myelofibrosis, underwent an allogeneic stem cell transplantation from his human leukocyte antigen-matched brother in June 2006. He was admitted to the hospital for a possible flare of graft-versus-host disease (GVHD) of the gut. His medications included tacrolimus, budesonide, and bechlamethasone for immunosuppression and pantoprazole. A stool sample was positive for Clostridium difficile toxin A on October 31, 2006, and he was started on oral metronidazole.

Topics: Anti-Infective Agents; Anti-Inflammatory Agents; Beclomethasone; Biopsy; Budesonide; Clostridioides difficile; Colonoscopy; Enterocolitis, Pseudomembranous; Feces; Hematopoietic Stem Cell Transplantation; Humans; Immunosuppressive Agents; Infection Control; Male; Metronidazole; Middle Aged; Oncology Nursing; Primary Myelofibrosis; Risk Factors; Tacrolimus; Vancomycin

Topics: Budesonide; Colitis, Collagenous; Colitis, Microscopic; Colonoscopy; Enterocolitis, Pseudomembranous; Female; Glucocorticoids; Humans; Middle Aged

Topics: Aged; Budesonide; Clostridioides difficile; Colitis, Microscopic; Colitis, Ulcerative; Colonoscopy; Enterocolitis, Pseudomembranous; Fecal Microbiota Transplantation; Glucocorticoids; Humans; Male

Pseudomembranous collagenous colitis is a rare pathological condition, not related to infectious agents, and characterized by thickening of the subepithelial collagen and formation of pseudomembranes. We report one such case, which responded to budesonide treatment after failures of previous approaches given, being unaware of the correct diagnosis.

Topics: Aged; Biopsy; Budesonide; Cholestyramine Resin; Colitis, Collagenous; Colon; Colonoscopy; Enterocolitis, Pseudomembranous; Female; Glucocorticoids; Humans; Predictive Value of Tests; Treatment Outcome

"Pseudomembranous collagenous colitis" is a morphologic variant of collagenous colitis in which active inflammation with pseudomembrane formation is prominent and which has been associated with infectious, toxic, and ischemic etiologies. However, extracolonic morphologic findings in patients with pseudomembranous collagenous colitis have not been previously described. Here, we present a case of a patient with pseudomembranous collagenous colitis with abnormal extracolonic findings. These include gastric antral mucosa with histologic features reminiscent of ischemic injury and reactive gastropathy with intraepithelial lymphocytosis and partial villous atrophy in the duodenal and ileal biopsies. The findings in the small intestinal biopsies resemble those seen in enteric mucosa in patients with conventional collagenous colitis. Our pathologic findings as well as the clinical course of the patient further emphasize the clinical and histologic similarities shared by pseudomembranous collagenous colitis and conventional collagenous colitis.

Topics: Aged; Budesonide; Colitis, Collagenous; Colon; Duodenum; Endoscopy, Gastrointestinal; Enterocolitis, Pseudomembranous; Female; Gastric Mucosa; Glucocorticoids; Humans; Ileum; Intestinal Mucosa; Intestine, Small; Pyloric Antrum; Treatment Outcome