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Isabel José Dionísio de Sousa1, Nuno Bonito1, Ana Pais1

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A patient with colon cancer developed eosinophilic colitis after chemotherapy. Treatment with budesonide resolved the symptoms, highlighting a potential adverse effect of chemotherapy.

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Area of Science:

  • Gastroenterology
  • Oncology
  • Pathology

Background:

  • A 57-year-old male diagnosed with Stage III colon cancer underwent surgery and adjuvant chemotherapy.
  • Received 12 cycles of FOLFOX 4 (5-fluorouracil, calcium folinate, oxaliplatin) chemotherapy from July 2010 to March 2011.
  • Followed by a period of routine surveillance.

Observation:

  • Approximately one year post-chemotherapy, the patient experienced nocturnal diarrhea.
  • Persistent peripheral eosinophilia was noted in blood counts (585-1300 eosinophils/µL).
  • Colonoscopy revealed eosinophilic infiltration of the colon.

Findings:

  • Histological examination confirmed eosinophilic colitis.
  • The patient was treated with a short course of budesonide.
  • Symptoms resolved completely following budesonide treatment.

Implications:

  • Chemotherapy, specifically FOLFOX 4, may be associated with the development of eosinophilic colitis.
  • Peripheral eosinophilia can be an indicator of chemotherapy-induced gastrointestinal side effects.
  • Budesonide appears to be an effective treatment for chemotherapy-induced eosinophilic colitis.