Drug induced gastro-intestinal tract lesions: A pathologist point of view

The number of drugs available to clinicians, especially targeted therapies, grows continuously. Some drugs are known to cause frequent digestive adverse effects, which may affect the gastro-intestinal tract in a diffuse or localized manner. Some treatments may leave relatively pathognomonic deposits, but histological lesions of iatrogenic origin are mostly non-specific. The diagnostic and etiological approach is often complex because of these non-specific aspects and also because (1) a single type of drug may cause different histological lesions, (2) different drugs may cause identical histological lesions, (3) the patient may receive different drugs, and (4) drug-induced lesions may mimic other pathological entities such as inflammatory bowel disease, celiac disease, or graft versus host disease. The diagnosis of iatrogenic gastroin-testinal tract injury therefore requires close anatomic-clinical correlation. The iatrogenic origin can only be formally established if the symptomatology improves when the incriminating drug is stopped. This review aims to present the different histological patterns of gastrointestinal tract iatrogenic lesions, the potentially incriminate drugs, as well as the histological signs to look for in order to help the pathologist to distinguish an iatrogenic injury from another pathology of the gastrointestinal tract.& COPY; 2023 Elsevier Masson SAS. All rights reserved.

Automated summary

The number of available drugs for clinicians, particularly targeted therapies, is continuously increasing. Some drugs are known to cause frequent digestive adverse effects which can affect the gastrointestinal tract in different ways. The diagnosis of iatrogenic gastrointestinal tract injury requires close correlation between anatomic and clinical aspects, and the cessation of the incriminating drug may help establish the iatrogenic origin.