Archives of Pathology & Laboratory Medicine
Context: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been known to produce various clinical gastrointestinal side effects and histopathologic changes. It has been reported that NSAID usage is associated with isolated colitis in the periappendiceal orifice region. This study aimed to further evaluate the clinicopathologic features of 16 patients with isolated colitis limited to the cecum or periappendiceal orifice region.
Design: A retrospective review was performed on biopsy specimens from 16 patients with histologically proven colitis (focal active colitis with no chronicity) limited to the cecum or periappendiceal orifice. No significant pathologic changes in the terminal ileum or other parts of the colon were identified in cases studied. Patients with a history of colorectal tumor or inflammatory bowel diseases were excluded from the study. Relevant clinical history, follow-up studies, and endoscopic findings were evaluated.
Results: Erosion, ulceration, and erythema were the main endoscopic findings in the cases studied. Among 16 cases, 9 (56%) had a history of routine NSAID usage. Among these 8 patients, 7 demonstrated resolution of pathologic abnormality after cessation of the drugs following repeated colonoscopy. Seven patients (44%) had nonroutine NSAID usage. After follow-up examination, none of the patients had infectious disease of the gastrointestinal tract or inflammatory bowel disease.
Conclusions: Our results confirm previously reported findings of a strong association of isolated colitis in the cecum or periappendiceal orifice region with NSAIDs. Our data support the conclusion that pathologic changes of isolated colitis are reversible after the cessation of NSAIDs.
Pokharel A, Li W. Association of isolated colitis with nonsteroidal anti-inflammatory drug usage. Arch Path Lab Med. 2022 Sep;146(9):e3-e4. doi:10.5858/arpa.2022-0231-AB.