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She had no gastrointestinal symptoms or other health problems. Tocilizumab-induced colitis was considered likely, and the drug was discontinued. Metronidazole was also prescribed because of possible <jats:italic>Clostridium difficile<\/jats:italic>-associated colitis. 3 months later, a repeat colonoscopy showed no improvement of the colitis. The methotrexate was also discontinued, and folinic acid was prescribed daily for 2\u2005weeks, leading to complete resolution of the colitis observed at repeat colonoscopy.<\/jats:p>","DOI":"10.1136\/bcr-2016-217771","type":"journal-article","created":{"date-parts":[[2016,11,25]],"date-time":"2016-11-25T06:15:15Z","timestamp":1480054515000},"page":"bcr2016217771","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Asymptomatic colitis induced by low-dose methotrexate"],"prefix":"10.1136","volume":"2016","author":[{"given":"Toshikazu","family":"Ozeki","sequence":"first","affiliation":[{"name":"Chubu Rosai Hospital, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiro","family":"Fujita","sequence":"additional","affiliation":[{"name":"Chubu Rosai Hospital, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,11,25]]},"reference":[{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM194806032382301"},{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.39480","article-title":"2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis","volume":"68","author":"Singh","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204573"},{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.4","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jbspin.2015.08.006","article-title":"Severe apoptotic enteropathy caused by methotrexate treatment for rheumatoid arthritis","volume":"83","author":"Toquet","year":"2016","journal-title":"Joint Bone Spine"},{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2003.12.003"},{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.6","first-page":"84","article-title":"Methotrexate induced colitis","volume":"61","author":"Novak","year":"1976","journal-title":"Nebr Med J"},{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.7","first-page":"314","article-title":"Methotrexate: a perspective of its use in the treatment of rheumatic diseases","volume":"100","author":"Willkens","year":"1982","journal-title":"J Lab Clin Med"},{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.8","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/0140-6736(92)90271-4","article-title":"Pseudomembranous colitis complicating chemotherapy","volume":"339","author":"Iveson","year":"1992","journal-title":"Lancet"},{"key":"2025082803482305000_2016.nov25_2.bcr2016217771.9","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:3<493::AID-CNCR2820030310>3.0.CO;2-8"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-217771","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:48:33Z","timestamp":1756378113000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-217771"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,25]]},"references-count":9,"alternative-id":["10.1136\/bcr-2016-217771"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-217771","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2016,11,25]]}}}