title: [A case of pseudomembranous colitis in a juvenile rheumatoid arthritis patient taking methotrexate].
abstract: Pseudomembranous colitis is mainly caused by antibiotics and Clostridium difficile infection. But conditions such as gastrointestinal surgery, antacid medication, anti-neoplastic agent or immunosuppressive agent which influences the normal flora of colon can induce colitis without the administration of any antibiotics. We experienced a 13 year-old male who was taking low-dose methotrexate for juvenile rheumatoid arthritis complained diarrhea and abdominal pain for 3 weeks. Sigmoidoscopic findings revealed diffuse patch yellowish pseudomembranes on the rectum. Histologic finding was compatible to pseudomembranous colitis. His symptom was improved after stop taking methotrexate and the administration of metronidazole. If a patient treated with immunosuppressive agents or antineoplastic agents complains diarrhea, fever or abdominal pain and has not improved with conservative care, pseudomembranous colitis should be taken into account as a differential diagnosis and prompt treatment is required for better prognosis.
authors.affiliation: Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ji Han
authors.initials: JH
authors.lastname: Yu
authors.forename: Na Young
authors.initials: NY
authors.lastname: Kim
authors.forename: Hae Min
authors.initials: HM
authors.lastname: Lee
authors.forename: Ha Ni
authors.initials: HN
authors.lastname: Lee
authors.forename: Hyo Jun
authors.initials: HJ
authors.lastname: Ahn
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Kyu Yong
authors.initials: KY
authors.lastname: Choi
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008795:Metronidazole / Q000627:therapeutic use; D012812:Sigmoidoscopy; D014057:Tomography, X-Ray Computed
chemical_list: D000890:Anti-Infective Agents; D018501:Antirheumatic Agents; D008795:Metronidazole; D008727:Methotrexate