A case of carbidopa/levodopa associated colitis mimicking inflammatory bowel disease
Carbidopa/levodopa is widely used in the management of Parkinson’s disease. We report a 77-year-old male with Parkinson’s disease who developed severe, protracted pancolitis and ileitis after 5-months of treatment with carbidopa/levodopa. The clinical presentation and endoscopic findings initially r...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-06-01
|
| Series: | Human Pathology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772736X22000603 |
| _version_ | 1811293200065757184 |
|---|---|
| author | Michael J. Steel James Conner Sandra Nelles Richard Kirsch |
| author_facet | Michael J. Steel James Conner Sandra Nelles Richard Kirsch |
| author_sort | Michael J. Steel |
| collection | DOAJ |
| description | Carbidopa/levodopa is widely used in the management of Parkinson’s disease. We report a 77-year-old male with Parkinson’s disease who developed severe, protracted pancolitis and ileitis after 5-months of treatment with carbidopa/levodopa. The clinical presentation and endoscopic findings initially resembled acute infectious colitis and later inflammatory bowel disease. The patient was unresponsive to intravenous corticosteroids and biologic therapy. Biopsies showed severe colitis with some features suggesting a drug effect (e.g. prominent crypt apoptoses, attenuated and regenerating crypts, and crypt dropout). Discontinuation of carbidopa/levodopa was associated with clinical and endoscopic resolution of the colitis. Levodopa, in combination with benserazide was later re-introduced, without a recurrence of the patient’s gastrointestinal symptoms. We therefore propose carbidopa as the likely cause of colitis in this case. |
| first_indexed | 2024-04-13T04:58:01Z |
| format | Article |
| id | doaj.art-53d874b7557d4cd39fcfe7e689ea7433 |
| institution | Directory Open Access Journal |
| issn | 2772-736X |
| language | English |
| last_indexed | 2024-04-13T04:58:01Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Human Pathology Reports |
| spelling | doaj.art-53d874b7557d4cd39fcfe7e689ea74332022-12-22T03:01:25ZengElsevierHuman Pathology Reports2772-736X2022-06-0128300648A case of carbidopa/levodopa associated colitis mimicking inflammatory bowel diseaseMichael J. Steel0James Conner1Sandra Nelles2Richard Kirsch3Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Corresponding author at: Department of Pathology and Laboratory Medicine Mount Sinai Hospital, 600 University Ave, Toronto, ON M5G 1X5, Canada.Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, CanadaDepartment of Gastroenterology, Trillium Health Partners – Mississauga Hospital, Mississauga, ON, CanadaDepartment of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, CanadaCarbidopa/levodopa is widely used in the management of Parkinson’s disease. We report a 77-year-old male with Parkinson’s disease who developed severe, protracted pancolitis and ileitis after 5-months of treatment with carbidopa/levodopa. The clinical presentation and endoscopic findings initially resembled acute infectious colitis and later inflammatory bowel disease. The patient was unresponsive to intravenous corticosteroids and biologic therapy. Biopsies showed severe colitis with some features suggesting a drug effect (e.g. prominent crypt apoptoses, attenuated and regenerating crypts, and crypt dropout). Discontinuation of carbidopa/levodopa was associated with clinical and endoscopic resolution of the colitis. Levodopa, in combination with benserazide was later re-introduced, without a recurrence of the patient’s gastrointestinal symptoms. We therefore propose carbidopa as the likely cause of colitis in this case.http://www.sciencedirect.com/science/article/pii/S2772736X22000603CarbidopaLevodopaMedication-induced colitisMimic of primary inflammatory bowel disease |
| spellingShingle | Michael J. Steel James Conner Sandra Nelles Richard Kirsch A case of carbidopa/levodopa associated colitis mimicking inflammatory bowel disease Human Pathology Reports Carbidopa Levodopa Medication-induced colitis Mimic of primary inflammatory bowel disease |
| title | A case of carbidopa/levodopa associated colitis mimicking inflammatory bowel disease |
| title_full | A case of carbidopa/levodopa associated colitis mimicking inflammatory bowel disease |
| title_fullStr | A case of carbidopa/levodopa associated colitis mimicking inflammatory bowel disease |
| title_full_unstemmed | A case of carbidopa/levodopa associated colitis mimicking inflammatory bowel disease |
| title_short | A case of carbidopa/levodopa associated colitis mimicking inflammatory bowel disease |
| title_sort | case of carbidopa levodopa associated colitis mimicking inflammatory bowel disease |
| topic | Carbidopa Levodopa Medication-induced colitis Mimic of primary inflammatory bowel disease |
| url | http://www.sciencedirect.com/science/article/pii/S2772736X22000603 |
| work_keys_str_mv | AT michaeljsteel acaseofcarbidopalevodopaassociatedcolitismimickinginflammatoryboweldisease AT jamesconner acaseofcarbidopalevodopaassociatedcolitismimickinginflammatoryboweldisease AT sandranelles acaseofcarbidopalevodopaassociatedcolitismimickinginflammatoryboweldisease AT richardkirsch acaseofcarbidopalevodopaassociatedcolitismimickinginflammatoryboweldisease AT michaeljsteel caseofcarbidopalevodopaassociatedcolitismimickinginflammatoryboweldisease AT jamesconner caseofcarbidopalevodopaassociatedcolitismimickinginflammatoryboweldisease AT sandranelles caseofcarbidopalevodopaassociatedcolitismimickinginflammatoryboweldisease AT richardkirsch caseofcarbidopalevodopaassociatedcolitismimickinginflammatoryboweldisease |