Case report: Pentoxifylline treatment in microscopic colitis

Thomas G. Cotter, Amrit K. Kamboj, Stephen Bradley Hicks, William J. Tremaine, Edward Vincent Loftus, Jr, Darrell S. Pardi

Research output: Contribution to journalArticle

Abstract

Rationale: Microscopic colitis is a common cause of diarrhea. Pentoxifylline, a xanthine derivative with anti-tumor necrosis factoralpha properties, is prescribed for intermittent claudication and other disorders. Our goal was to evaluate the outcomes of patients with microscopic colitis treated with pentoxifylline. Patient concerns: Nine patients with microscopic colitis (8 collagenous colitis and 1 lymphocytic colitis) seen at Mayo Clinic, Rochester, between January 1, 1997 and November 30, 2016, were included. The median age was 56.9 years (range 51.6-60.2), 8 were female (89%), and the median disease duration was 64.8 months (range 60-109). The indications for treatment were budesonide refractoriness in 7 patients, budesonide dependence in 1 patient, and budesonide intolerance in 1 patient. Diagnoses: A histological diagnosis of microscopic colitis was confirmed in all patients. Interventions: Pentoxifylline 400 mg three times a day was used for a median of 3 months (range 2.5-8.3). Outcomes: Complete response occurred in 1 patient (11%) and partial response in 3 patients (33%). The patient who achieved complete response was treated with pentoxifylline due to budesonide intolerance, and completed 43 months of successful maintenance therapy. There were no adverse effects reported. Lessons: The majority of budesonide-experienced patients with active microscopic colitis did not respond to pentoxifylline. However, it was well-tolerated, with 1 patient achieving long-term remission and one-third of the cohort having a partial response. Larger controlled studies are required to evaluate the efficacy of pentoxifylline and predictors of response in microscopic colitis. In particular, patients who are not budesonide-refractory may be more likely to respond. Abbreviations: CC = collagenous colitis, LC = lymphocytic colitis, MC = microscopic colitis, TNF-α = tumor necrosis factoralpha.

Original languageEnglish (US)
Article number8355
JournalMedicine (United States)
Volume96
Issue number46
DOIs
StatePublished - Nov 1 2017

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Microscopic Colitis
Pentoxifylline
Budesonide
Therapeutics
Lymphocytic Colitis
Collagenous Colitis
Necrosis
Intermittent Claudication
Xanthine

Keywords

  • Collagenous colitis
  • Lymphocytic colitis
  • Microscopic colitis
  • Pentoxifylline

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cotter, T. G., Kamboj, A. K., Hicks, S. B., Tremaine, W. J., Loftus, Jr, E. V., & Pardi, D. S. (2017). Case report: Pentoxifylline treatment in microscopic colitis. Medicine (United States), 96(46), [8355]. https://doi.org/10.1097/MD.0000000000008355

Case report : Pentoxifylline treatment in microscopic colitis. / Cotter, Thomas G.; Kamboj, Amrit K.; Hicks, Stephen Bradley; Tremaine, William J.; Loftus, Jr, Edward Vincent; Pardi, Darrell S.

In: Medicine (United States), Vol. 96, No. 46, 8355, 01.11.2017.

Research output: Contribution to journalArticle

Cotter, Thomas G. ; Kamboj, Amrit K. ; Hicks, Stephen Bradley ; Tremaine, William J. ; Loftus, Jr, Edward Vincent ; Pardi, Darrell S. / Case report : Pentoxifylline treatment in microscopic colitis. In: Medicine (United States). 2017 ; Vol. 96, No. 46.
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