Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2024; 12(3): 607-615
Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.607
Ischemic colitis induced by a platelet-raising capsule: A case report
Chen-Lu Wang, Ze-Kun Si, Guo-Hong Liu, Chen Chen, Hui Zhao, Lei Li
Chen-Lu Wang, Ze-Kun Si, Lei Li, The Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong Province, China
Guo-Hong Liu, Chen Chen, Hui Zhao, Department of Gastroenterology, The Affiliated Hospital of Shandong Second Medical University, Weifang 261000, Shandong Province, China
Author contributions: Li L is responsible for proposing and presenting the case and organizing the writing of the article; Wang CL was mainly responsible for drafting the manuscript; Si ZK and Liu GH were responsible for collecting the data; Chen C and Zhao H are in charge of organizing the figures and tables.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Li, Doctor, Chief Physician, Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, No. 2428 Yuhe Road, Kuiwen District, Weifang 261000, Shandong Province, China. htlilei@163.com
Received: October 12, 2023
Peer-review started: October 12, 2023
First decision: December 6, 2023
Revised: December 9, 2023
Accepted: January 4, 2024
Article in press: January 4, 2024
Published online: January 26, 2024
Processing time: 91 Days and 18.1 Hours
Abstract
BACKGROUND

Ischemic colitis (IC) is also known as colon ischemia and is caused by colon vascular occlusion or nonocclusion, which results in a reduced blood supply to the colon and is not significant enough to maintain the metabolic function of cells, leading to intestinal wall ischemia. Its main symptoms include abdominal pain, diarrhea, and bloody stool. In severe cases, intestinal gangrene, peritonitis, intestinal stenosis and even intestinal obstruction may occur. IC induced by long-term use of certain special drugs is relatively rare in clinical practice. This article describes the clinical diagnosis and treatment of a typical case and provides a new treatment idea for the treatment of IC.

CASE SUMMARY

The patient was admitted to the hospital with "abdominal pain for half a month and bloody stool with mucous and pus for 3 d" and was diagnosed with "IC". Symptomatic and supportive treatment, such as antibiotics (levofloxacin), acid inhibition and stomach protection, fluid replenishment, and intravenous nutrition, was given. The patient's colonic ulcers were considered to be related to the oral administration of platelet (PLT)-raising capsules; the patient was asked to stop PLT-raising drugs for selective review via colonoscopy, and antibiotics and mesalazine enteric-coated tablets were stopped. Under the guidance of hematology consultation, 60 mg of methylprednisolone was given in combination with PLT infusion to increase the PLT. After treatment, the patient's condition stabilized, the patient’s stool turned yellow, the patient’s symptoms improved, and the patient was allowed to leave the hospital.

CONCLUSION

PLT-raising capsules can lead to IC, so clinicians should have a full understanding of the application of these drugs in the treatment of various causes of thrombocytopenia, weigh the advantages and disadvantages, and observe patients closely.

Keywords: Platelet-raising capsule; Ischemic colitis; Drug-related; Colonic ulcer; Case report

Core Tip: Ischemic colitis (IC) caused by a platelet (PLT)-raising capsule is relatively rare in the clinic. We reported the clinical diagnosis and treatment of a patient with IC caused by the use of a PLT-raising capsule and summarized the clinical diagnosis and treatment characteristics of these patients by reviewing the relevant literature.