A Case of Pseudomembranous Colitis in a Juvenile Rheumatoid Arthritis Patient Taking Methotrexate.
10.4166/kjg.2010.56.6.387
- Author:
Jihan YU
1
;
Na Young KIM
;
Hae Min LEE
;
Ha Ni LEE
;
Hyo Jun AHN
;
Sang Woo KIM
;
Kyu Yong CHOI
Author Information
1. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. viper@catholic.ac.kr
- Publication Type:Case Report ; English Abstract
- Keywords:
Pseudomembranous colitis;
Methotrexate;
Immunosuppressive agents;
Chemotherapy;
Diarrhea
- MeSH:
Abdominal Pain/etiology;
Adolescent;
Anti-Infective Agents/therapeutic use;
Antirheumatic Agents/*adverse effects/therapeutic use;
Arthritis, Juvenile Rheumatoid/*drug therapy;
Diagnosis, Differential;
Diarrhea/etiology;
Enterocolitis, Pseudomembranous/*diagnosis/drug therapy/pathology;
Humans;
Male;
Methotrexate/*adverse effects/therapeutic use;
Metronidazole/therapeutic use;
Sigmoidoscopy;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2010;56(6):387-390
- CountryRepublic of Korea
- Language:Korean
-
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.
