Methotrexate-Induced Apoptotic Colopathy in Crohn's Disease

Vibhu Chittajallu; Wendy Liu; Vu Nguyen

doi:10.14309/crj.0000000000000980

Methotrexate-Induced Apoptotic Colopathy in Crohn's Disease

ACG Case Rep J. 2023 Feb 23;10(2):e00980. doi: 10.14309/crj.0000000000000980. eCollection 2023 Feb.

Authors

Vibhu Chittajallu¹, Wendy Liu², Vu Nguyen¹

Affiliations

¹ Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Cleveland, OH.
² Division of Clinical Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH.

Abstract

Apoptotic colopathy is a pattern of injury not frequently associated with Crohn's disease (CD) despite its association with medications used in CD management. We describe a patient with CD on methotrexate who underwent a diagnostic colonoscopy for abdominal pain and diarrhea, with biopsies demonstrating apoptotic colopathy. After methotrexate discontinuation, repeat colonoscopy demonstrated resolution of apoptotic colopathy in addition to diarrhea improvement.

Keywords: Crohn's disease; methotrexate; pathology.