De Petris Giovanni, Caldero Sonia Gatius, Chen Longwen, Xiao Shu-Yuan, Dhungel Bal M, Spizcka Amy J Wendel, Lam-Himlin Dora
1Mayo Clinic Arizona, Scottsdale, AZ, USA.
Int J Surg Pathol. 2014 May;22(3):202-11. doi: 10.1177/1066896913502230. Epub 2013 Sep 10.
In keeping with the stated goal of providing the surgical pathologist with tools to recognize abnormalities of the gastrointestinal (GI) tract due to drugs (AGIDS), in part II of this review we embark in a more organ-based description of AGIDS. Adequate space is given to the numerous adverse gastrointestinal effects of nonsteroidal anti-inflammatory drugs. Pill esophagitis, esophagitis dissecans, proton pump inhibitors' effects, diaphragm disease, and the recently described effects of drugs such as olmesartan, mycophenolate, and of compounds such as yttrium-90 are highlighted among several others. The inclusion of drug effects in the differential diagnosis of "conventional" diseases (such as gastric antral vascular ectasia, graft-versus-host disease, ischemic colitis, acute colitis, collagenous enteritis, inflammatory bowel disease) is underscored to avoid sometimes significant diagnostic pitfalls. We reiterate the message of the necessary collaboration between pathologist and clinician in the recognition of these entities to provide the best patient care.
为了实现为外科病理学家提供识别药物所致胃肠道（GI）异常（AGIDS）的工具这一既定目标，在本综述的第二部分，我们将对AGIDS进行更基于器官的描述。文中为非甾体抗炎药众多的不良胃肠道效应留出了足够篇幅。在其他诸多效应中，重点介绍了药丸性食管炎、夹层食管炎、质子泵抑制剂的效应、隔膜病，以及最近描述的奥美沙坦、霉酚酸酯等药物和钇-90等化合物的效应。强调将药物效应纳入“传统”疾病（如胃窦血管扩张、移植物抗宿主病、缺血性结肠炎、急性结肠炎、胶原性肠炎、炎症性肠病）的鉴别诊断中，以避免有时出现重大的诊断陷阱。我们重申病理学家和临床医生在识别这些病变时进行必要协作以提供最佳患者护理的重要性。
