Histopathological changes in the gastrointestinal tract due to drugs: an update for the surgical pathologist (part I of II)

Int J Surg Pathol. 2014 Apr;22(2):120-8. doi: 10.1177/1066896913502229. Epub 2013 Sep 10.

Abstract

Abnormalities of the gastrointestinal (GI) tract due to drugs (AGIDs) are numerous and have significant impact. The aim of this narrative review is to help the practicing surgical pathologist recognize selected AGIDs. The adverse drug effects presented were chosen with an emphasis on recent and significant pathological and clinical contributions. The selection was based on a thorough review of the PUBMED-based literature and on the authors' opinions and experience. In the first part of the review, diagnostic abnormalities due to crystals (eg, iron, biphosphonates, nonsystemic drugs), mitosis arresting drugs (colchicine, taxanes), and biological agents, especially ipilimumab, are discussed. Some AGIDs' histopathologic features can be easily recognized. It is however the clinical correlation that in many cases of AGIDs will provide the necessary support for a drug effect diagnosis. The identification of AGIDs requires heightened awareness of the medical team in which close collaboration of pathologists and clinicians cannot be overemphasized.

Keywords: adverse gastrointestinal tract drug effect; crystals in the gastrointestinal tract; ipilimumab; nonsteroidal anti-inflammatory drugs; olmesartan.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Gastrointestinal Diseases / chemically induced
  • Gastrointestinal Diseases / pathology*
  • Gastrointestinal Tract / drug effects
  • Gastrointestinal Tract / pathology*
  • Humans
  • Pathology, Surgical

Substances

  • Anti-Inflammatory Agents, Non-Steroidal