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[A case of pseudomembranous colitis in a juvenile rheumatoid arthritis patient taking methotrexate]

Ji Han Yu1, Na Young Kim, Hae Min Lee

  • 1Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi
|December 22, 2010
PubMed

Insights

Pseudomembranous colitis can occur without antibiotics, triggered by factors like immunosuppressive drugs. Early diagnosis and treatment are crucial for better patient outcomes.

Area of Science:

  • Gastroenterology
  • Immunology

Background:

  • Pseudomembranous colitis is typically linked to antibiotics and Clostridium difficile.
  • However, other factors like immunosuppressive agents can disrupt gut flora and induce colitis.

Observation:

  • A 13-year-old male on methotrexate for juvenile rheumatoid arthritis presented with diarrhea and abdominal pain.
  • Sigmoidoscopy revealed pseudomembranes in the rectum, confirmed by histology.

Findings:

  • Methotrexate cessation and metronidazole treatment led to symptom improvement.
  • This case highlights non-antibiotic-induced pseudomembranous colitis.

Implications:

  • Consider pseudomembranous colitis in patients on immunosuppressants or antineoplastics with persistent gastrointestinal symptoms.
  • Prompt diagnosis and treatment are vital for improved prognosis in these cases.

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