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Microscopic Colitis Secondary to Leflunomide: A Case Report.
Mohamed A Ebrahim1, Eli A Zaher1, Parth Patel1
1Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA.
Cureus
|June 11, 2024
Summary
Microscopic colitis, a cause of chronic diarrhea, was diagnosed in a rheumatoid arthritis patient after starting leflunomide. Stopping the drug resolved symptoms, indicating leflunomide as the likely cause of this rare condition.
Area of Science:
- Gastroenterology
- Rheumatology
- Pharmacology
Background:
- Microscopic colitis (MC) presents as chronic watery diarrhea, diagnosed via histology.
- Rheumatoid arthritis (RA) patients may experience gastrointestinal side effects from medications.
Observation:
- A 63-year-old female with RA developed persistent diarrhea after initiating leflunomide.
- Colonoscopy appeared normal, but colonic biopsies confirmed microscopic colitis.
Findings:
- Discontinuation of leflunomide resulted in complete resolution of the patient's diarrhea.
- This suggests leflunomide was the causative agent for microscopic colitis in this case.
Implications:
- Leflunomide-induced microscopic colitis is a rare but potential adverse drug reaction.
- Clinicians should consider drug-induced colitis in unexplained diarrhea, especially in patients on leflunomide.
- Thorough medication review is critical for diagnosing and managing unexplained diarrhea.
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