Role of colonoscopy in diagnosis of capecitabine associated ileitis:Two case reports
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摘要
BACKGROUND Capecitabine is considered a first line agent in adjuvant therapy for breast and colorectal cancer. However,cases of severe diarrhea have been reported with increasing frequency in recent years. When diarrhea is severe and prolonged,capecitabine associated ileitis should be considered as a possible etiology.CASE SUMMARY Herein,we present two cases of capecitabine ileitis,specifically involving the terminal ileum and ascending colon. We will demonstrate the disease course and treatment modalities applied to alleviate this condition,as well as discuss the merits of using colonoscopy to aid in diagnosis.CONCLUSION Ultimately our cases demonstrate that symptomatic management with traditional anti-diarrheal medications is largely ineffective. Prompt recognition and discontinuation of capecitabine is an imperative step in proper management of this condition and colonoscopy with biopsy can be helpful when the diagnosis is unclear.
BACKGROUND Capecitabine is considered a first line agent in adjuvant therapy for breast and colorectal cancer. However,cases of severe diarrhea have been reported with increasing frequency in recent years. When diarrhea is severe and prolonged,capecitabine associated ileitis should be considered as a possible etiology.CASE SUMMARY Herein,we present two cases of capecitabine ileitis,specifically involving the terminal ileum and ascending colon. We will demonstrate the disease course and treatment modalities applied to alleviate this condition,as well as discuss the merits of using colonoscopy to aid in diagnosis.CONCLUSION Ultimately our cases demonstrate that symptomatic management with traditional anti-diarrheal medications is largely ineffective. Prompt recognition and discontinuation of capecitabine is an imperative step in proper management of this condition and colonoscopy with biopsy can be helpful when the diagnosis is unclear.
BACKGROUND Capecitabine is considered a first line agent in adjuvant therapy for breast and colorectal cancer. However,cases of severe diarrhea have been reported with increasing frequency in recent years. When diarrhea is severe and prolonged,capecitabine associated ileitis should be considered as a possible etiology.CASE SUMMARY Herein,we present two cases of capecitabine ileitis,specifically involving the terminal ileum and ascending colon. We will demonstrate the disease course and treatment modalities applied to alleviate this condition,as well as discuss the merits of using colonoscopy to aid in diagnosis.CONCLUSION Ultimately our cases demonstrate that symptomatic management with traditional anti-diarrheal medications is largely ineffective. Prompt recognition and discontinuation of capecitabine is an imperative step in proper management of this condition and colonoscopy with biopsy can be helpful when the diagnosis is unclear.
引文
1 Saif MW,Katirtzoglou NA,Syrigos KN.Capecitabine:an overview of the side effects and their management.Anticancer Drugs 2008;19:447-464[PMID:[[18418212 DOI:10.1097/CAD.0b013e3282f945aa]
2 Walko CM,Lindley C.Capecitabine:a review.Clin Ther 2005;27:23-44[PMID:[[15763604 DOI:10.1016/j.clinthera.2005.01.005]
3 Radwan R,Namelo WC,Robinson M,Brewster AE,Williams GL.Ileitis secondary to oral capecitabine treatment?Case Rep Med 2012;2012:154981[PMID:[[23251164 DOI:10.1155/2012/154981]
4 Soares PM,Mota JM,Souza EP,Justino PF,Franco AX,Cunha FQ,Ribeiro RA,Souza MH.Inflammatory intestinal damage induced by 5-fluorouracil requires IL-4.Cytokine 2013;61:46-49[PMID:[[23107827 DOI:10.1016/j.cyto.2012.10.003]
5 Lee SF,Chiang CL,Lee AS,Wong FC,Tung SY.Severe ileitis associated with capecitabine:Two case reports and review of the literature.Mol Clin Oncol 2015;3:1398-1400[PMID:[[26807255 DOI:10.3892/mco.2015.635]
6 Barton D.Ulcerative ileitis secondary to adjuvant capecitabine for colon cancer:a case report.UICCWorld Cancer Congress,Washington,DC,July 2006,84-41.
7 Al-Gahmi AM,Kerr IG,Zekri JM,Zagnoon AA.Capecitabine-induced terminal ileitis.Ann Saudi Med2012;32:661-662[PMID:[[23396034 DOI:10.5144/0256-4947.2012.661]
8 Mokrim M,Aftimos PG,Errihani H,Piccart-Gebhart M.Breast cancer,DPYD mutations and capecitabine-related ileitis:description of two cases and a review of the literature.BMJ Case Rep 2014;2014:pii:bcr2014203647[PMID:[[24748142 DOI:10.1136/bcr-2014-203647]
9 van Hellemond IEG,Thijs AM,Creemers GJ.Capecitabine-Associated Terminal Ileitis.Case Rep Oncol2018;11:654-659[PMID:[[30483093 DOI:10.1159/000492781]
10 Bouma G,Imholz AL.[Ileitis following capecitabine use].Ned Tijdschr Geneeskd 2011;155:A3064[PMID:[[21486509]
2 Walko CM,Lindley C.Capecitabine:a review.Clin Ther 2005;27:23-44[PMID:[[15763604 DOI:10.1016/j.clinthera.2005.01.005]
3 Radwan R,Namelo WC,Robinson M,Brewster AE,Williams GL.Ileitis secondary to oral capecitabine treatment?Case Rep Med 2012;2012:154981[PMID:[[23251164 DOI:10.1155/2012/154981]
4 Soares PM,Mota JM,Souza EP,Justino PF,Franco AX,Cunha FQ,Ribeiro RA,Souza MH.Inflammatory intestinal damage induced by 5-fluorouracil requires IL-4.Cytokine 2013;61:46-49[PMID:[[23107827 DOI:10.1016/j.cyto.2012.10.003]
5 Lee SF,Chiang CL,Lee AS,Wong FC,Tung SY.Severe ileitis associated with capecitabine:Two case reports and review of the literature.Mol Clin Oncol 2015;3:1398-1400[PMID:[[26807255 DOI:10.3892/mco.2015.635]
6 Barton D.Ulcerative ileitis secondary to adjuvant capecitabine for colon cancer:a case report.UICCWorld Cancer Congress,Washington,DC,July 2006,84-41.
7 Al-Gahmi AM,Kerr IG,Zekri JM,Zagnoon AA.Capecitabine-induced terminal ileitis.Ann Saudi Med2012;32:661-662[PMID:[[23396034 DOI:10.5144/0256-4947.2012.661]
8 Mokrim M,Aftimos PG,Errihani H,Piccart-Gebhart M.Breast cancer,DPYD mutations and capecitabine-related ileitis:description of two cases and a review of the literature.BMJ Case Rep 2014;2014:pii:bcr2014203647[PMID:[[24748142 DOI:10.1136/bcr-2014-203647]
9 van Hellemond IEG,Thijs AM,Creemers GJ.Capecitabine-Associated Terminal Ileitis.Case Rep Oncol2018;11:654-659[PMID:[[30483093 DOI:10.1159/000492781]
10 Bouma G,Imholz AL.[Ileitis following capecitabine use].Ned Tijdschr Geneeskd 2011;155:A3064[PMID:[[21486509]