Gastrointestinal pathologic findings of teriflunomide associated diarrhea

Abstract

Background

Diarrhea is generally a benign and self-limited adverse effect of teriflunomide. Small intestinal pathology has yet to be described with teriflunomide associated diarrhea.

Objective

To report small intestinal pathology in teriflunomide associated diarrhea.

Methods

Small intestinal and colonic biopsies were obtained from a patient with teriflunomide associated diarrhea.

Results

Small intestinal biopsy demonstrated blunting of villi, increased intraepithelial lymphocytes and expansion of lamina propria. Gliadin and t-transglutaminase antibodies were negative. Diarrhea resolved following elimination of teriflunomide with cholestyramine.

Conclusion

This is the first reported case of small intestinal inflammation similar to celiac disease in teriflunomide associated diarrhea.