De Petris Giovanni, Gatius Caldero Sonia, Chen Longwen, Xiao Shu-Yuan, Dhungel Bal M, Wendel Spizcka Amy J, Lam-Himlin Dora
1Mayo Clinic Arizona, Scottsdale, AZ, USA.
Int J Surg Pathol. 2014 Apr;22(2):120-8. doi: 10.1177/1066896913502229. Epub 2013 Sep 10.
Abnormalities of the gastrointestinal (GI) tract due to drugs (AGIDs) are numerous and have significant impact. The aim of this narrative review is to help the practicing surgical pathologist recognize selected AGIDs. The adverse drug effects presented were chosen with an emphasis on recent and significant pathological and clinical contributions. The selection was based on a thorough review of the PUBMED-based literature and on the authors' opinions and experience. In the first part of the review, diagnostic abnormalities due to crystals (eg, iron, biphosphonates, nonsystemic drugs), mitosis arresting drugs (colchicine, taxanes), and biological agents, especially ipilimumab, are discussed. Some AGIDs' histopathologic features can be easily recognized. It is however the clinical correlation that in many cases of AGIDs will provide the necessary support for a drug effect diagnosis. The identification of AGIDs requires heightened awareness of the medical team in which close collaboration of pathologists and clinicians cannot be overemphasized.
药物所致胃肠道(GI)异常(AGIDs)种类繁多且影响重大。本叙述性综述的目的是帮助外科病理科医生识别特定的AGIDs。所呈现的药物不良反应侧重于近期具有重要意义的病理和临床贡献。选择基于对以PUBMED为基础的文献的全面回顾以及作者的观点和经验。在综述的第一部分,讨论了由晶体(如铁、双膦酸盐、非系统性药物)、有丝分裂阻滞药物(秋水仙碱、紫杉烷类)和生物制剂(尤其是伊匹单抗)引起的诊断异常。一些AGIDs的组织病理学特征易于识别。然而,在许多AGIDs病例中,临床相关性将为药物效应诊断提供必要支持。AGIDs的识别需要医疗团队提高认识,其中病理学家和临床医生的密切合作再怎么强调也不为过。