De Novo Development of Distal Jejunal and Duodenal Adenomas After 41 Months of Teduglutide Treatment in a Patient With Short-Bowel Syndrome: A Case Report

JPEN J Parenter Enteral Nutr. 2021 Mar;45(3):652-656. doi: 10.1002/jpen.1982. Epub 2020 Aug 21.

Abstract

The glucagon-like peptide-2 (GLP-2) analogue teduglutide is a medical treatment option for patients with short-bowel syndrome-associated chronic intestinal failure. Because studies in mice have shown that GLP-2 analogues may promote the growth of colonic neoplasms, surveillance colonoscopies before and during teduglutide therapy were recommended. The occurrence of small-intestinal neoplasms has not been reported so far, except for a recent report about de novo development of hamartomatous duodenal polyps. We report a case of de novo development of small-intestinal premalignant adenomatous polyps in both bulbar duodenum and distal jejunum in a patient treated with teduglutide for 41 months. Therefore, additional endoscopic surveillance of the upper gastrointestinal tract may be advised during teduglutide therapy for early detection and removal of potential small-bowel adenomas.

Keywords: duodenal adenoma; endoscopy; glucagon-like peptide 2; intestinal failure; jejunal adenoma; parenteral nutrition; short bowel syndrome; teduglutide.

Publication types

  • Case Reports

MeSH terms

  • Adenoma* / complications
  • Adenoma* / drug therapy
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Jejunum
  • Peptides
  • Short Bowel Syndrome* / complications
  • Short Bowel Syndrome* / drug therapy

Substances

  • Gastrointestinal Agents
  • Peptides
  • teduglutide