Beaugerie L, Pardi D S
Department of Gastroenterology, Saint-Antoine Hospital, Pierre and Marie Curie University, Paris, France.
Aliment Pharmacol Ther. 2005 Aug 15;22(4):277-84. doi: 10.1111/j.1365-2036.2005.02561.x.
The pathophysiology of microscopic colitis is unknown, although it is thought to be because of an abnormal immune reaction to luminal antigens in predisposed hosts. Specific antigens have not been proved, although various infectious triggers and drugs have been proposed. The responsibility of several drugs has been questioned, some with strong clinical and/or histological evidence suggesting causality. The issue of drug-induced microscopic colitis is important because of the burden of this disease. Thus, any case that can be cured by withdrawal of a drug must be identified. In this report, we propose a scoring system for drug-induced microscopic colitis, adapting existing criteria of drug causality, and review the literature using this framework. Based on this review, several drugs are identified with intermediate or high likelihood of inducing microscopic colitis. Finally, we suggest how to treat individual patients suspected of having drug-induced colitis according to the level of evidence for that particular drug.
显微镜下结肠炎的病理生理学尚不清楚，尽管人们认为这是由于易感宿主对肠腔抗原的异常免疫反应所致。虽然已经提出了各种感染诱因和药物，但尚未证实存在特定抗原。几种药物的责任受到质疑，有些有强有力的临床和/或组织学证据表明存在因果关系。由于这种疾病的负担，药物性显微镜下结肠炎问题很重要。因此，必须识别出任何通过停用药物可治愈的病例。在本报告中，我们提出了一种药物性显微镜下结肠炎的评分系统，采用现有的药物因果关系标准，并使用该框架回顾文献。基于这一回顾，确定了几种诱导显微镜下结肠炎可能性为中等或高的药物。最后，我们建议根据特定药物的证据水平，如何治疗疑似患有药物性结肠炎的个体患者。
