Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2025; 13(6): 94330
Published online Feb 26, 2025. doi: 10.12998/wjcc.v13.i6.94330
Hydroxyurea-related ileocecal region ulcers as a rare complication: A case report
Wen-Jin Yuan, Yi-Juan Zheng, Bing-Rong Zhang, Yi-Jie Lin, You Li, Yan-Yan Qiu, Xue-Ping Yu
Wen-Jin Yuan, Yi-Juan Zheng, Bing-Rong Zhang, Yi-Jie Lin, You Li, Yan-Yan Qiu, Xue-Ping Yu, Department of Infection Disease, Clinical Medical Research Center for Bacterial and Fungal Infectious Diseases of Fujian province, Fujian Medical University Affiliated First Quanzhou Hospital, Quanzhou 362000, Fujian Province, China
Co-first authors: Wen-Jin Yuan and Yi-Juan Zheng.
Author contributions: Yuan WJ, Zheng YJ, Zhang BR, Lin YJ, Li Y, Qiu YY, and Yu XP collected the data; Yuan WJ, Zeng YJ, Zhang BR, Lin YJ, and Yu XP analysised the data; Yuan WJ and Zeng YJ wrote the manuscript; Yu XP edited the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Supported by National Natural Science Foundation of China, No. 82370604; Major Science and Technology innovation Project of Fujian Province, No. 2023Y9269; and Natural Science Foundation of Fujian Province, China, No. 2023J01239.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
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: Xue-Ping Yu, MD, PhD, Deputy Director, Department of Infection Disease, Clinical Medical Research Center for Bacterial and Fungal Infectious Diseases of Fujian province, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou 362000, Fujian Province, China. xpyu15@fudan.edu.cn
Received: March 15, 2024
Revised: September 28, 2024
Accepted: November 5, 2024
Published online: February 26, 2025
Processing time: 254 Days and 19.4 Hours
Abstract
BACKGROUND

Hydroxyurea, an antimetabolite, is frequently prescribed for various hematological disorders, and its common side effects include gastrointestinal problems, cutaneous or mucosal lesions and pyrexia/fever.

CASE SUMMARY

This study reports the case of a 67-year-old woman who developed recurrent abdominal pain after 10 years of continuous hydroxyurea therapy for primary thrombocythemia. Colonoscopy revealed an ileocecal ulcer. After discontinuing hydroxyurea therapy for 6 months, follow-up colonoscopy showed a significant reduction in the ulceration.

CONCLUSION

We consider cecal ulcers as a rare complication of hydroxyurea therapy which typically resolves upon stopping the drug.

Keywords: Hydroxyurea; Ulcer; Abdominal pain; Thrombocythemia; Colonoscopy; Case report

Core Tip: Ileocecal ulcers related to hydroxyurea are a rare adverse reaction and may be associated with drug hypersensitivity vasculitis and Behcet's disease. However, its specific pathogenic mechanism remains unknown. To date, only four cases of ileocecal ulcers have been reported worldwide, including three cases of the condition being complicated by pyrexia/fever, oral ulcers, and xerosis cutis. Pathological findings of ileocecal ulcers in these four cases revealed inflammatory changes that improved after hydroxyurea was discontinued. This report aims to raise awareness of the rare complication of hydroxyurea-induced ileocecal ulcers.