[Neutropenic enteropathy associated with autoimmune diseases. A more aggressive presentation].
BACKGROUND
There is just one case report dealing with neutropenic enteropathy associated with autoimmune diseases.


METHODS
An autopsy analysis of neutropenic enteropathy in autoimmune and hematologic diseases was carried on. Gross findings and slides were reviewed. A blind analysis is of the mucosal lesions in small and large intestine as well as of the clinical course was made.


RESULTS
Seventeen cases of neutropenic enteropathy were found a once period of 13 years (1,068 autopsies). Fourteen cases were seen in patients with hematologic diseases and three in patients with autoimmune diseases. Acute symptoms had a 6-day evolution and were characterized by abdominal pain, diarrhea, ascitis, and fever in autoimmune diseases. Extension of colonic damage was 58 and 13% in small bowel. Cases associated with hematologic diseases had longer clinical course with fever abdominal pain and colonic lesions in 21% of the surface and small bowel lesions in 6% of the mucosa. No acute inflammatory infiltrate around the necrotic zones was observed in either group Azathioprine, steroids, methotrexate, and alkylating agents were associated to neutropenia.


CONCLUSIONS
Clinical evolution and morphologic findings were more severe in neutropenic enteropathy associated with autoimmune diseases than in patients with hematologic diseases.
Chavarri-Guerra
Y
Y
Departamento de Patología, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Bornstein-Quevedo
L
L
Reyes-Gutiérrez
E
E
Gamboa-Domínguez
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001327:Autoimmune Diseases / Q000150:complications*; D005260:Female; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology* / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology*
D000970:Antineoplastic Agents