Úlceras en intestino delgado por glucosamina con MSM: Reporte de un caso / Case report: Ulcers in the small intestine due to glucosamine and methylsulfonylmethane (MSM) use

RESUMEN

Reportamos el caso de una paciente con dolor abdominal, anemia por deficiencia de hierro y sangre oculta positiva en materia fecal. Sin sangrado evidente. Historia de osteoartritis en manejo con glucosamina con metilsulfonilmetano. Endoscopia superior y colonoscopia no explican sangrado. Cápsula endoscópica muestra múltiples úlceras circunferenciales algunas de ellas con sangrado activo. Se descarta uso de AINES y enfermedad de Crohn. Al mes de suspender suplemento nutricional hay resolución de síntomas y de anemia con sangre oculta negativa. No hubo recurrencia de síntomas.

ABSTRACT

We report on the case of a female patient with abdominal pain, iron deficiency anemia who tested positive for fecal occult blood but had no overt gastrointestinal bleeding. Patient had a known history of osteoarthritis and used Glucosamine - MSM. Both upper GI endoscopy and colonoscopy were negative. Capsule endoscopy showed multiple concentric ulcers, several of which were actively bleeding. Patient reported no use of NSAIDs, and there was no evidence of Crohn's disease. Nutritional supplements were stopped. After four weeks abdominal pain improved, patient had anemia and a fecal occult blood test was negative. Symptoms have not recurred.