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. 2022 Sep 13;62(9):1279–1285. doi: 10.2169/internalmedicine.0434-22

Table 2.

Summary of Reported Cases of CPA-associated Enteritis.

No. Reference Age/
sex
Background autoimmune disease Symptoms Affected organ Colonoscopy findings CT findings Pathological findings Treatments Total dose of CPA Outcomes of enteritis
1 (3) 60/M MPA Nausea Vomiting Diarrhea Small intestine Colon Denuded and erythematous mucosa Diffuse mural thickening Full-thickness mucosal ulceration and inflammation throughout the terminal ileum and colon CPA was continued for 1 month with dose reduction to 50 mg/day and subsequent discontinuation 2,100 mg Symptoms did not improve for more than 4 weeks; patient eventually died from ARDS.
2 (4) 61/F GPA Nausea Vomiting Diarrhea Stomach Duodenum Small intestine Colon Generalized edema from the transverse colon to the rectum Massive wall thickening with prominent contrast enhancement in the mucosa Mild inflammatory cellular infiltration, some granulation tissues, and ulcers Discontinuation of CPA Intensive supportive care 1,000 mg Symptoms did not improve for more than 4 months but eventually improved.
3 Our case 60/M MPA Nausea Vomiting Diarrhea Small intestine Colon Severe edema of the mucosa from the ileum to the rectum with redness and erosion Extensive wall thickening in the small intestine and colon Interstitium showing slightly granulation tissue-like nonspecific inflammation Discontinuation of CPA Intensive supportive care 500 mg Symptoms did not improve for more than 4 months but eventually improved.

M: male, F: female, CT: computed tomography, CPA: cyclophosphamide, MPA: microscopic polyangiitis, GPA: granulomatosis with polyangiitis, ARDS: acute respiratory distress syndrome