Mastocytic enterocolitis as a rare cause of chronic diarrhea in a patient with rheumatoid arthritis
Department of Internal Medicine, State Hospital Mürzzuschlag, Mürzzuschlag, Austria.Wiener klinische Wochenschrift (Impact Factor: 0.84). 05/2011; 123(9-10):297-8. DOI: 10.1007/s00508-011-1566-7
The prevalence of chronic diarrhea within the U.S. population has been reported to be as high as five per cent, and numerous causes have been identified. Especially in patients suffering from rheumatoid arthritis drug therapy should be considered as possible cause. We report a case of chronic diarrhea triggered by mastocytic enterocolitis in a patient suffering from rheumatoid arthritis. Systemic mastocytosis and other causes of chronic diarrhea, especially therapy with methotrexate, were carefully ruled out. Treatment with desloratadin and ranitidine was initiated and led to a rapid and persistent amelioration of clinical symptoms. The diagnosis of mastocytic enterocolitis should be considered in patients with chronic diarrhea and normal clinical, laboratory, as well as endoscopical work-up.
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ABSTRACT: Collagenous and lymphocytic colitis are common causes of chronic watery diarrhea that are characterized by distinct histopathologic abnormalities without endoscopically visible lesions and are summarized as microscopic colitis. Several variants of microscopic colitis have been described, although their clinical significance still has to be defined. Preserved mucosal architecture is a histologic hallmark of microscopic colitis and distinguishes the disease from inflammatory bowel disease (IBD). In addition to architectural abnormalities, the diagnosis of IBD rests on characteristic inflammatory changes. Differential diagnosis of IBD mainly includes prolonged infection and diverticular disease-associated colitis, also known as segmental colitis associated with diverticulosis.Gastroenterology clinics of North America 09/2012; 41(3):561-80. DOI:10.1016/j.gtc.2012.06.005 · 2.82 Impact Factor
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