Wilcox Gilbert M, Mattia Anthony R
Department of Gastroenterology, Maine Medical Center, Portland, ME, USA.
J Clin Gastroenterol. 2009 Jul;43(6):551-3. doi: 10.1097/MCG.0b013e31817d3fa1.
The aim of this study was to determine whether proton pump inhibitors other than lansoprazole might be associated with microscopic colitis.
Lansoprazole exposure has been associated with diarrhea and microscopic colitis, but this relationship has not been described with other proton pump inhibitors.
Cases of microscopic colitis from a consultative gastroenterology practice were collected and reviewed for proton pump inhibitor exposure. Standard clinical, endoscopic, and biopsy findings were analyzed.
A case series of 4 patients is described in which subjects developed classic symptoms of lymphocytic-collagenous colitis with typical mucosal histopathology during treatment with omeprazole/esomeprazole. Symptoms promptly stopped and mucosal biopsies returned to normal with drug withdrawal. Disease quickly recurred in 2 patients who were reexposed to the drugs, one with biopsy documented recurrent collagenous colitis.
Some cases of microscopic colitis seem to be associated with omeprazole/esomaprazole exposure. These results have epidemiologic, diagnostic, and therapeutic ramifications, which are discussed.
本研究旨在确定除兰索拉唑之外的质子泵抑制剂是否可能与显微镜下结肠炎相关。
兰索拉唑暴露与腹泻及显微镜下结肠炎有关，但其他质子泵抑制剂与这种关系尚未见描述。
收集来自一家咨询胃肠病科诊所的显微镜下结肠炎病例，并对质子泵抑制剂暴露情况进行回顾。分析标准临床、内镜及活检结果。
描述了一个包含4例患者的病例系列，这些患者在使用奥美拉唑/埃索美拉唑治疗期间出现淋巴细胞性胶原性结肠炎的典型症状及典型黏膜组织病理学表现。停药后症状迅速消失，黏膜活检恢复正常。2例再次接触药物的患者疾病迅速复发，其中1例活检证实为复发性胶原性结肠炎。
部分显微镜下结肠炎病例似乎与奥美拉唑/埃索美拉唑暴露有关。讨论了这些结果在流行病学、诊断及治疗方面的影响。
