BMJ open gastroenterology · 2019
Adult-onset autoimmune-type enteropathy: potential relationship to an adverse drug reaction.
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Chetty Runjan, Cino Maria, Okrainec Allan
Аннотация
OBJECTIVE: To describe an example of adult-onset autoimmune enteropathy (AIE) that coincided with drug-induced reaction.
DESIGN: A 54-year-old patient was presented with Stevens-Johnson syndrome after a course of quinolones. This was followed shortly thereafter by epigastric pain, diarrhoea and weight loss. She also developed an autoimmune neutropenia.
RESULTS: Several biopsies were performed from the upper and lower gastrointestinal tract (GIT). The duodenal biopsies showed intraepithelial lymphocytosis; therefore, coeliac disease was considered. However, confirmatory serology was negative and the patient did not respond to a gluten-free/gliadin-free diet. Both upper and lower GIT biopsies consistently showed an absence of goblet cells resembling the changes of an AIE.
CONCLUSION: This is an unusual case of autoimmune-pattern enteropathy in an adult that was potentially drug-induced.
DESIGN: A 54-year-old patient was presented with Stevens-Johnson syndrome after a course of quinolones. This was followed shortly thereafter by epigastric pain, diarrhoea and weight loss. She also developed an autoimmune neutropenia.
RESULTS: Several biopsies were performed from the upper and lower gastrointestinal tract (GIT). The duodenal biopsies showed intraepithelial lymphocytosis; therefore, coeliac disease was considered. However, confirmatory serology was negative and the patient did not respond to a gluten-free/gliadin-free diet. Both upper and lower GIT biopsies consistently showed an absence of goblet cells resembling the changes of an AIE.
CONCLUSION: This is an unusual case of autoimmune-pattern enteropathy in an adult that was potentially drug-induced.