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Varelas, AI; Fürst, S; Langner, C.
Mixed lymphocytic and collagenous inflammation of the entire gastrointestinal tract under therapy with serotonin and norepinephrine reuptake inhibitors.
Virchows Arch. 2022; 481(5):779-783 Doi: 10.1007/s00428-022-03351-2 (- Case Report) [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Langner Cord
Co-Autor*innen der Med Uni Graz
Fürst Stefan
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Abstract:
Drug-induced injury to the gastrointestinal tract has gained growing significance in recent years, and the list of causative medications keeps expanding. Herein, we present the case of a 45-year-old female with major depressive disorder treated with two serotonin and norepinephrine reuptake inhibitors (venlafaxine and duloxetine). She developed nausea and weight loss. Endoscopic evaluation of the upper and lower gastrointestinal tract rendered grossly normal mucosa in all segments. Histological examination, however, revealed lymphocytic esophagitis, collagenous gastritis, celiac disease-like intraepithelial lymphocytosis of the duodenum, and incomplete collagenous colitis. Gastrointestinal side effects of psychoactive drugs are largely underrecognized. This is the first report of a mixed lymphocytic and collagenous pattern of injury affecting esophagus, stomach, duodenum, and colon triggered by combined treatment with venlafaxine and duloxetine. In patients with unclear symptoms, obtaining biopsies from mucosa that is normal upon endoscopic inspection may render decisive clues for clinical management.
Find related publications in this database (using NLM MeSH Indexing)
Female - administration & dosage
Humans - administration & dosage
Middle Aged - administration & dosage
Serotonin and Noradrenaline Reuptake Inhibitors - adverse effects
Serotonin - administration & dosage
Duloxetine Hydrochloride - adverse effects
Venlafaxine Hydrochloride - administration & dosage
Depressive Disorder, Major - pathology
Gastrointestinal Tract - pathology
Inflammation - pathology

Find related publications in this database (Keywords)
Drug-induced injury
Lymphocytic esophagitis
Collagenous gastritis
Lymphocytic duodenitis
Collagenous colitis
Microscopic colitis
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