PMC10462905_01
Pathology before and after treatment with teduglutide. (A) Duodenal mucosa before treatment with teduglutide with mild villous blunting, crypt hyperplasia, and slightly increased intraepithelial lymphocytes. (B) Duodenal mucosa after treatment with teduglutide with a definite improvement in villous architecture. (C) Rectosigmoid colon before treatment with teduglutide with increased intraepithelial and crypt lymphocytosis, surface epithelial degeneration and mucin depletion with abundant lymphoplasmacytic infiltrate in the lamina propria, overall findings consistent with lymphocytic colitis. (D) Rectum after treatment with teduglutide with normal colorectal mucosa indicative of complete resolution in rectum.
fmed-10-1231565-g001.jpg
PMC10462905_01_fmed-10-1231565-g001.jpg
fig1
A pathology report showed duodenal mucosa with mild villous blunting, crypt hyperplasia, and slightly increased intraepithelial lymphocytes (Figure 1A). IgA and absent celiac HLA-DQ genes. In rectosigmoid colon, mucosa with increased intraepithelial and crypt lymphocytosis, surface epithelial degeneration and mucin depletion with abundant lymphoplasmacytic infiltrate in the lamina propria were also seen, overall findings consistent with lymphocytic colitis (Figure 1C). Repeat biopsies were performed in February 2019, approximately 7 months after the initiation of teduglutide, which showed small bowel mucosa with a definite improvement in villous architecture (Figure 1B) and normal colorectal mucosa indicative of complete resolution in rectum (Figure 1D).
Timeline of treatment changes and patient outcomes.
fmed-10-1231565-g002.jpg
PMC10462905_01_fmed-10-1231565-g002.jpg
fig2
Figure 2 summarizes the timeline of treatment changes and patient outcomes.