S3379 Capecitabine-Induced Rapid Onset Terminal Ileitis in Patient With Stage III Sigmoid Adenocarcinoma

Abstract

uL, and high CMV PCR at 4,068 IU/mL. Qualitative fecal fat positive. Negative blood cultures, fungal culture, mycobacterial blood, and sputum cultures. Negative stool testing for Clostridium difficile, fecal leukocyte antigen, cryptosporidium, Giardia antigen, Salmonella, Shigella, Campylobacter species, ova and parasites. CT abdomen/pelvis showed a loculated fluid collection in the splenic bed that was drained with negative cultures. On EGD and colonoscopy, the duodenum and terminal ileum (TI) had petechial lesions which on pathologic examination revealed diffuse AFB and villous blunting in TI. Normal colonic biopsies. Biopsies were negative for CMV, celiac disease, and Whipple's disease. Diagnosed with disseminated atypical MAC(most likely M. kansasii) in the setting of HIV-AIDS. CMV viremia was thought to be an incidental finding without GI manifestations. Treatment for disseminated MAC with ethambutol, isoniazid, rifampin, azithromycin, pyridoxine, and for HIV with Dolutegravir & Truvada started. However, he deteriorated despite treatment and died from multi-organ failure 16 days later. (Figure ) Discussion: Diarrhea, a common gastrointestinal symptom in AIDS, has many etiologies. DMAC is associated with higher morbidity and mortality. So physicians must be familiar with the causes and utilize endoscopic interventions as needed for effective diagnosis and treatment in AIDS patients.[3377] Figure 1. Petechial lesions in the terminal ileum noted on endoscopy.

Capecitabine-Induced Ileitis during Neoadjuvant Pelvic Radio-Chemotherapy for Locally Advanced Rectal Cancer: A Case Report with Literature Review

“…We reported a case of acute ileitis observed in a patient who received a diagnosis of locally advanced rectal cancer and subsequently underwent concomitant RT-CHT with capecitabine. The literature reports a total of eighteen other cases of ileitis induced by capecitabine, which are fully reported in Table 2 [21][22][23][24][25][26][27][28][29][30][31][32][33][34]. No clearly identifiable risk factors have been established.…”