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Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...

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Related Experiment Video

Updated: May 20, 2026

Murine Appendectomy Model of Chronic Colitis Associated Colorectal Cancer by Precise Localization of Caecal Patch
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Murine Appendectomy Model of Chronic Colitis Associated Colorectal Cancer by Precise Localization of Caecal Patch

Published on: August 24, 2019

Rituximab-associated colitis with colonic perforation requiring subtotal colectomy in systemic sclerosis.

Yuta Kuhara1,2, Shinnosuke Uegami3, Masahide Miyata3

  • 1Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 3-2-1, Kasumi, Minami-ku, 734-8551, Hiroshima, Japan. y.kuhara010613@gmail.com.

Clinical Journal of Gastroenterology
|May 19, 2026
PubMed
Summary

Rituximab-associated colitis is a rare toxicity with delayed onset and nonspecific symptoms. This case shows it can mimic inflammatory bowel disease and progress to perforation, even with initial improvement.

Keywords:
ColitisInflammatory bowel diseaseIntestinal perforationRituximabScleroderma systemic

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Area of Science:

  • Gastroenterology
  • Immunology
  • Rheumatology

Background:

  • Rituximab-associated colitis is a rare, potentially severe adverse event.
  • It presents with nonspecific symptoms and can have a prolonged latency period after treatment.

Purpose of the Study:

  • To report a case of rituximab-associated colitis with prolonged latency.
  • To highlight the diagnostic challenges and potential complications of this condition.

Main Methods:

  • Case report of a patient with systemic sclerosis and interstitial lung disease.
  • Clinical presentation, diagnostic workup including colonoscopy and computed tomography, and histological findings are described.
  • Immunohistochemistry was performed to characterize the inflammatory infiltrate.

Main Results:

  • The patient developed colitis 195 days after her last rituximab infusion.
  • Initial investigations were inconclusive, and the condition mimicked inflammatory bowel disease.
  • Despite initial improvement with prednisolone, the patient developed colonic perforation requiring subtotal colectomy.
  • Histology revealed deep ulcerations and noncaseating granulomas with a CD4-predominant lymphocytic infiltrate.

Conclusions:

  • Rituximab-associated colitis can present with significant delay and mimic inflammatory bowel disease.
  • Early biopsy and vigilant radiologic monitoring are crucial for timely diagnosis and management.
  • Colonic perforation is a potential complication, even with apparent biochemical improvement.