Non-steroidal anti-inflammatory drugs induced colopathy, mimicking Crohn's disease

Abstract

The authors describe the case of a 47-year-old woman with rheumatoid arthritis who took, in the long term, nonsteroidal anti-inflammatory drugs (NSAID). Her state was complicated by sideropenic anaemia with high inflammatory humoral response during complete rheumatological therapy. She was examined by a gastroenterologist. Colonoscopy revealed severe colitis, which was preliminarily evaluated as a Crohn's disease and a complete therapy including infliximab was administered. However, her condition did not improve and repeated colonoscopy was carried out. This investigation revealed a worse finding with severe continuous ulcerationsof the large bowel. The diagnosis was re-evaluated for NSAID induced colopathy. The previous therapy was stopped and colectomy with ileosigmoideostomy was performed. After surgery the patient was feeling well, had no anaemia, and the humoral anti-inflammatory response decreased. The authors present a review of NSAID induced colopathy which can mimic Crohn's disease.