NSAID (Diclofenac) induced apoptotic colitis-A case report and review of literature
Journal Title: IJAR-Indian Journal of Applied Research - Year 2016, Vol 6, Issue 3
Abstract
Colon can be involved by a variety of etiological agents like infection (bacterial or viral), parasitic (entamoeba), idiopathic (Inflammatory bowel disease -Crohn’s disease or ulcerative colitis), ischemic colitis and various drugs. The patient usually presents with pain abdomen, bleeding per rectum and diarrhea. Here we describe one such case of drug (NSAID) induced colitis. Methods:- A 75 year old female presented with diarrhea and bleeding per rectum for last one year. On colonoscopy there were multiple ulcers present in left colon. Histopathological examination showed multiple colonic fragments with maintained crypt architecture. The lamina propria showed dense mixed inflammation rich in eosinophils with focal areas of hyalinisation.. In addition many crypts showed apoptosis with cytoplasmic and nuclear remnants. Results:- Finally, a diagnosis of diclofenac induced apoptotic colitis was made based on clinical and histopathological findings. Conclusion:- Biopsy sampling is mandatory in cases of colitis and we should always take history of drug intake in patients presented with colitis having unusual morphological features on biopsy.Because rapid therapeutic response can be achieved on discontinuation of NSAID.
Authors and Affiliations
Dr. Vikash, Dr. Neeraj Dhameja, Dr. V. K Dixit
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