Is microscopic colitis a drug-induced disease?
Microscopic colitis (MC) is diagnosed in up to 13% of patients investigated for chronic diarrhea, particularly in middle-aged and elderly patients. Recent studies have suggested an etiological role for various drugs, including nonsteroidal anti-inflammatory drugs and proton pump inhibitors. To ascertain the potential role for drug exposure in the development of MC, we performed a systematic review based on a MEDLINE search and conducted a meta-analyses on the available data. We also give an overview of the case reports and studies illustrating the role of drugs in inducing MC. A number of hypotheses are formulated with regard to the potential pathophysiological mechanisms in drug-induced MC. However, confirmative evidence is still largely lacking. Considering the high number of drug users and the relatively low incidence of MC, it is more likely that drug-induced cases of MC are the result of an idiosyncratic reaction.
Department of Internal Medicine, Division of Gastroenterology-Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands. daniel.keszthelyi@maastrichtuniversity.nl
Daniel
D
Keszthelyi
John
J
Penders
Ad A
AA
Masclee
Marieke
M
Pierik
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D046728:Colitis, Microscopic / Q000139:chemically induced*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D006801:Humans; D054328:Proton Pump Inhibitors / Q000009:adverse effects*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors