Severe colitis associated with docetaxel use:A report of four cases  

作　　者：Andres F Carrion Peter J Hosein Eugene M Cooper Gilberto Lopes Liset Pelaez Caio M Rocha-Lima 

机构地区：[1]Department of Medicine,Division of Gastroenterology,Hematology/Oncology,Pathology,University of Miami Miller School of Medicine [2]Johns Hopkins Singapore International Medical Center

出　　处：《World Journal of Gastrointestinal Oncology》2010年第10期390-394,共5页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：Diarrhea is a common side effect of chemotherapy.Pseudomembranous colitis is a well known complication of antibiotic treatment that can also be observed,albeit rarely,with certain chemotherapeutic agents.We present four cases of severe colitis in patients undergoing treatment with taxane-based chemotherapy for pancreatic,lung and breast cancer.None of them had recently received antibiotics.One patient presented with a bowel perforation and three had endoscopic findings of pseudomembranous colitis.Two of these three patients had negative stool toxin assays for Clostridium difficile.In the patient presenting with perforation,an emergency left hemicolectomy was performed and the pathological findings in the colon were acute inflammation and ischemic necrosis;the other three patients were treated with oral vancomycin and/or oral or intravenous metronidazole leading to complete resolution of the symptoms.Apart from pseudomembranous colitis,we describe patients presenting with neutropenic enterocolitis as well as ischemic colitis after docetaxel use.These cases provide some insight into the spectrum and varied clinical presentations of severe colitis associated with taxane-based chemotherapy.Diarrhea is a common side effect of chemotherapy. Pseudomembranous colitis is a well known complication of antibiotic treatment that can also be observed, albeit rarely, with certain chemotherapeutic agents. We present four cases of severe colitis in patients undergoing treatment with taxane-based chemotherapy for pancreatic, lung and breast cancer. None of them had recently received antibiotics. One patient presented with a bowel perforation and three had endoscopic findings of pseudomembranous colitis. Two of these three patients had negative stool toxin assays for Clostridium difficile. In the patient presenting with perforation, an emergency left hemicolectomy was performed and the pathological findings in the colon were acute inflammation and ischemic necrosis; the other three patients were treated with oral vancomycin and/or oral or intravenous metronidazole leading to complete resolution of the symptoms. Apart from pseudomembranous colitis, we describe patients presenting with neutropenic enterocolitis as well as ischemic colitis after docetaxel use. These cases provide some insight into the spectrum and varied clinical presentations of severe colitis associated with taxane-based chemotherapy.

关 键 词：PSEUDOMEMBRANOUS COLITIS CHEMOTHERAPY CLOSTRIDIUM diffi cile DOCETAXEL 

分 类 号：R574.62[医药卫生—消化系统]