Linear mucosal defect may be characteristic of lansoprazole-associated collagenous colitis.
BACKGROUND
Although some cases of collagenous colitis have been induced by lansoprazole (LPZ), the clinicopathologic features of LPZ-associated collagenous colitis have not been elucidated.


OBJECTIVE
To elucidate the clinical, endoscopic, and histopathologic features of LPZ-associated collagenous colitis.


METHODS
Retrospective case study.


METHODS
The subjects were 13 patients with collagenous colitis diagnosed during a period from 2002 to 2007.


METHODS
The colonoscopic and histopathologic findings were compared retrospectively between 9 cases of LPZ use (LPZ group) and 4 cases without the use of LPZ (non-LPZ group).


RESULTS
A colonoscopy revealed a linear mucosal defect more frequently in the LPZ group (7 of 9 cases [78%]) than in the non-LPZ group (0 of 4 cases [0%], P = .02). Friable mucosa was also noted in 4 patients (44%) in the LPZ group but none in the non-LPZ group. The colonoscopic finding in the non-LPZ group was either normal mucosa or nonspecific minimal abnormalities, whereas patients in the LPZ group had either a linear mucosal defect, mucosal bleeding, or both (P = .001). On histologic examination, the subepithelial collagen band was thicker in patients in the LPZ group than in those in the non-LPZ group (median 45 vs 26.3 mum). All patients in the LPZ group recovered from diarrhea after discontinuance of LPZ.


CONCLUSIONS
A small number of patients.


CONCLUSIONS
Linear mucosal defects and friable mucosa may be characteristic colonoscopic findings in cases of LPZ-associated collagenous colitis.
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Junji
J
Umeno
Takayuki
T
Matsumoto
Shotaro
S
Nakamura
Yukihiko
Y
Jo
Shinichiro
S
Yada
Katsuya
K
Hirakawa
Ryuji
R
Yoshimura
Hajime
H
Yamagata
Tetsuji
T
Kudo
Atsushi
A
Hirano
Masaki
M
Gushima
Takashi
T
Yao
Yutaka
Y
Nakashima
Mitsuo
M
Iida
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D046729:Colitis, Collagenous / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000009:adverse effects; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D017494:Proton Pumps; D064747:Lansoprazole