Case Control Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2019; 25(8): 967-979
Published online Feb 28, 2019. doi: 10.3748/wjg.v25.i8.967
Triggers of histologically suspected drug-induced colitis
Thorsten Brechmann, Katharina Günther, Matthias Neid, Wolff Schmiegel, Andrea Tannapfel
Thorsten Brechmann, Katharina Günther, Wolff Schmiegel, Department of Gastroenterology and Hepatology, Ruhr-University Bochum, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bochum 44789, Germany
Matthias Neid, Andrea Tannapfel, Institute of Pathology, Ruhr-University Bochum, Bochum 44789, Germany
Wolff Schmiegel, Department of Internal Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum 44892, Germany
Author contributions: Schmiegel W, Brechmann T, and Tannapfel A developed the idea and designed the study. Brechmann T and Günther K collected and analysed the data. Neid M and Günther K performed the histopathological reassessment. Brechmann T drafted the manuscript. Günther K, Neid M, Schmiegel S, and Tannapfel A revised the manuscript.
Institutional review board statement: The study protocol was approved by the institutional review board of the Ruhr-university Bochum [registration number 16-5963] on the basis of the ethical guidelines of the Declaration of Helsinki and its later revisions.
Informed consent statement: Written, informed consents were obtained from all patients before specific examinations and procedures such as colonoscopy and biopsy. For this retrospective study informed consent was neither practicable nor necessary.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: All authors had unlimited access to the data.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Thorsten Brechmann, MD, Doctor, Senior Researcher, Department of Gastroenterology and Hepatology, Ruhr-University Bochum, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany.
Telephone: +49-234-3023411 Fax: +49-234-3026707
Received: November 27, 2018
Peer-review started: November 27, 2018
First decision: December 20, 2018
Revised: January 22, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: February 28, 2019
Core Tip

Core tip: Several drugs have been attributed to drug-induced colitis (DiC). In this systematical age- and gender-matched retrospective cohort study based on histopathological findings DiC was associated with drugs predominantly indicated for the treatment of cardiovascular and related diseases, nonsteroidal anti-inflammatory drugs, with atherosclerosis, particularly coronary heart disease, and hyperlipoproteinaemia. Histopathology was reassessed in three groups (DiC with atherosclerosis, DiC without atherosclerosis and ischaemic colitis each); both DiC groups presented milder inflammation than ischaemic colitis; DiC patients with atherosclerosis exhibited histological features from both other groups. In conclusion, atherosclerosis and microcirculatory disturbances seem to play an important pathogenetic role.