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Diagnosis and Clinical Features of Drug-induced Collagenous Colitis Kenji Yamazaki 1 , Seiji Shimizu 2 , Yoriko Hanai 3 , Tomoaki Shinohara 4 , Kinichi Hotta 5 , Kazuyoshi Yagi 6 , Shinji Nishiwaki 7 , Yasushi Fukutomi 8 , Takashi Ibuka 9 , Hiroshi Araki 9 , Masahito Shimizu 9 , Yoshio Mori 10 , Hitoshi Iwata 11 , Ryoji Kushima 12 1Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan 2Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company, Osaka, Japan 3Department of Gastroenterology, Chuno Kosei Hospital, Seki, Japan 4Department of Gastroenterology, Saku Central Hospital Advanced Care Center, Saku, Japan 5Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan 6Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Tsubame, Japan 7Department of Internal Medicine, Nishimino Kosei Hospital, Gifu, Japan 8Fukutomi Icyo Clinic, Gifu, Japan 9Department of Gastroenterology, Gifu University School of Medicine, Gifu, Japan 10Department of Pathology, Chuno Kosei Hospital, Seki, Japan 11Department of Diagnostic Pathology, Gifu Prefectural General Medical Center, Gifu, Japan 12Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Otsu, Japan Keyword: collagenous colitis , 薬剤性腸炎 , プロトンポンプ阻害薬 , 縦走潰瘍 , 急性腹症 pp.450-462
Published Date 2016/4/25
DOI https://doi.org/10.11477/mf.1403200598
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 We examined the medication history, endoscopic findings, and clinical features of 95 patients diagnosed with collagenous colitis(CC)at our hospital and joint research institutions. Seventy-five patients(78.9%)had a history of proton pump inhibitor(PPI)treatment. Forty-seven of the 70 patients(67.1%)who were taking lansoprazole(LPZ)were receiving concomitant treatment with drugs that were metabolized via cytochrome P-450 monooxygenase 3A4(CYP3A4). The remaining 20 patients(21.1%)were not administered PPI, although a relation of CC to drugs was unknown in six patients.

 The features of endoscopic findings showed no significant differences between patients treated and not treated with PPI. Longitudinal ulcers that were characteristic of LPZ-induced CC were observed in 20(26.7%)of 75 patients diagnosed with PPI-induced CC. In addition, four patients who had not been treated with PPI also had longitudinal ulcers.

 Six patients had no diarrheal symptoms, including two with severe abdominal pain and four with no symptom of CC. All six patients had longitudinal ulcers detected on endoscopy and were diagnosed with CC on histopathological examination.

 Our study highlights the need for reviewing the existing clinical protocols and diagnostic criteria for CC.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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