TABLE 3.

Proposed diagnostic criteria for anti-CD20 -induced de novo IBD.

Proposed diagnostic criteria for anti-CD20 de novo IBD
Major criteria
Exposure to an anti-CD20 drug in the previous year
Compatible symptoms that may include: fever, abdominal pain, watery or muco-bloody diarrhea.
CD20+ cell depletion in GI biopsy
Lymphoplasmacytic infiltrate (CD3+ T cells and CD79+ plasma cells) in the lamina propria
Clinical/endoscopic recovery after drug withdrawal and CD20+ cell recovery in intestinal mucosa
Minor criteria
Elevation of acute inflamation biomarkers in laboratory tests (CPR, ESR, lymphocytosis)
Compatible endoscopic findings: mucosal erythema with edema and patchy ulcers/erosions with predominant involvement of the ileum and proximal colon. Tendency to spare stomach and duodenum
Chronic active inflammation with cryptitis, goblet cell reduction, and superficial ulcers with areas of spared mucosa
Good response to glucocorticoid therapy
Absence of other possible aetiologies
Normal neutrophil count
Absence of infectious causes: CMV, Salmonella, Shigella, Campylobacter, E. coli, C. difficile.
Other comorbidities that could justify the pathology
Other drugs/toxics that could justify the pathology