Source: Zeitschrift fur Gastroenterologie Vol 56, #6, pp 573-577 Date: June 2018 URL: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-0596-7981 Severe eosinophilic colitis caused by neuropathic agents in a patient with chronic fatigue syndrome and functional abdominal pain: Case report and review of the literature ---------------------------------------------------------- Konstantinos C. Fragkos(1), John Barragry(1), Charisma Shahi Fernando(2), Marco Novelli(2), Joanna Begent(3), Natalia Zarate-Lopez(1) 1 GI Physiology Unit, Department of Gastroenterology, University College London Hospitals NHS Foundation Trust, London, United Kingdom. 2 Histopathology Department, University College London Hospitals NHS Foundation Trust, London United Kingdom. 3 Adolescent Unit, University College London Hospitals NHS Foundation Trust, London United Kingdom. Abstract Eosinophilic colitis is a rare clinical condition that belongs to the group of eosinophilic gastrointestinal disorders. Its occurrence can be primary or secondary to infection, medications, or autoimmune/hematological conditions. We present a case of a young female adult with severe chronic fatigue syndrome, widespread chronic pain, including functional abdominal pain, who developed severe eosinophilic colitis following successive treatments with gabapentin and pregabalin. On both occasions, symptoms manifested as abdominal pain, diarrhea, and eosinophilia and improved upon discontinuation of the medications. Magnetic resonance imaging of the small bowel demonstrated an ascending colon colitis, and endoscopic investigations confirmed florid colitis mainly in the ascending colon with biopsies demonstrating a dense eosinophilic infiltrate with micro-abscesses. Serum eosinophil counts correlated well with the timing of the agents' administration. There was no other organ involvement. Symptoms improved upon discontinuation of the drugs and steroid administration. Eosinophilic colitis is an exceptionally rare entity and its mechanism of action is still unclear. Suspicion of eosinophilic colitis should be raised if a patient presents with abdominal pain, diarrhea, and peripheral eosinophilia following treatment with pregabalin or gabapentin. Key words: gabapentin - pregabalin - eosinophilic colitis - myalgic encephalopathy - functional bowel disorder -------- (c) 2018 Georg Thieme Verlag KG
yes very interesting as these are the main drugs the NHS gives you if you get diagnosed with "CFS/ME"along with Amitryptiline
I do wonder that If this person had not been in London ( assumption due to hospital details) and/ or If this was to happen in a couple of years time with IAPT roll out / MUS agenda/ IBD and SNOWMED codings Just how seriously this would have been investigated....
