Levodopa/dopa decarboxylase inhibitor associated microscopic colitis: An under-recognized drug reaction.

BACKGROUND: Microscopic colitis is a form of inflammatory bowel disease characterized by profuse non-bloody watery diarrhea. Macroscopic abnormality is not present on colonoscopy, and it requires biopsy for diagnosis. Few cases have been attributed to levodopa/dopa-decarboxylase inhibitor therapy. METHOD: A retrospective cohort study of 21 patients on levodopa/benserazide and one patient on levodopa-carbidopa intestinal gel with clinically suspected or biopsy proven microscopic colitis. RESULTS: All 21 patients on oral levodopa/benserazide had resolution of diarrhea with cessation of the medication. Four patients discontinued levodopa permanently. Two were rechallenged with levodopa/benserazide without symptom recurrence. One patient on oral levodopa/carbidopa developed diarrhea only with intermittent dispersible levodopa/benserazide. 14 were switched to levodopa/carbidopa with resolution of diarrhea in 9 but symptom recurrence in 5. One patient on oral levodopa/benserazide developed profuse diarrhea when switched to levodopa-carbidopa intestinal gel. Of 7/22 patients who had colonoscopy and biopsy, 5 had histopathological proven microscopic colitis. CONCLUSION: levodopa/dopa-decarboxylase inhibitor induced microscopic colitis may be more common than previously suspected, with the potential to affect treatment compliance and therapeutic options.

Exploring the influence of ownership history on object valuation in typical development and autism.

Items with special histories (e.g. celebrity owners) or qualities (e.g. limited editions) are more valuable than similar "inauthentic" items. Typically developing (TD) children privilege authenticity and are particularly influenced by who objects belong to. Here, we explore why children and adults over-value items with special ownership histories and examine how autism spectrum disorder (ASD) affects object valuation. In Studies 1 and 2, TD children perceived items belonging to famous owners (with "good" or "bad" reputations) to be more valuable than similar items belonging to non-famous owners. However, they ascribed significantly higher values to items belonging to famous heroes than infamous villains when compared. Children with ASD did not over-value objects with special ownership histories, but their valuations were moderated by qualities unrelated to ownership (e.g. rarity). In Study 3, adults with ASD assigned high values to authentic items with special ownership histories but were more likely to keep inauthentic objects than neurotypical adults. Our findings show that association with a famous owner is sufficient to increase an item's value for TD children and adults (with and without ASD). The degree of added value may be determined by the famous owner's character for TD children, but not adults. By contrast, children with ASD value objects via a different strategy that prioritizes material qualities over ownership history. However, the awareness of authenticity displayed by adults with ASD suggests that the emergence of ownership history as an important influence on object evaluation may be developmentally delayed in ASD, rather than completely absent.