Adult-onset autoimmune-type enteropathy: potential relationship to an adverse drug reaction

What is it about?

Objective: To describe a form of drug-induced enteropathy that mimics autoimmune enteropathy.
Design: A 54-year old patient presented with Stevens-Johnson syndrome after a course of quinolones. This was followed shortly thereafter by epigastric pain, watery diarrhoea and loss of weight all of which has persisted for the last 8 years. She also developed an autoimmune neutropenia. 
Results: Several biopsies were performed from the upper and lower gastrointestinal tract (GIT). The duodenal biopsies showed intraepithelial lymphocytosis and coeliac disease was considered. However, confirmatory serology was negative and the patient did not respond to a gluten/gliadin-free diet. Both upper and lower GIT biopsies consistently showed an absence of goblet cells resembling the changes of an autoimmune enteropathy.
Conclusion: This is a unique case of drug-induced autoimmune-pattern enteropathy.


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