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Agnarsdóttir, Margrét; Gunnlaugsson, Ólafur; Örvar, Kjartan B.; Cariglia, Nick; Birgisson, Sigurbjörn; Björnsson, Sigurður; Thorgeirsson, Thorgeir E.; Jonasson, Jón G.

doi:10.1023/a:1015058611858

Cited by 121 publications

(13 citation statements)

References 12 publications

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“…[4] Studies from different developed countries have reported MC rates of 4%-13% in population cohorts with CWND of unknown origin. [2369–11] In this single-center study in Egypt, we found the rate to be 50%, which is similar to the highly prevalence rates reported in other developing countries such as Peru (40%) and Tunis (29.3%). [57]…”

Section: Discussionsupporting

confidence: 83%

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Prevalence of microscopic colitis in patients with chronic diarrhea in Egypt: A single-center study

Gado

Ebeid

Hindawi

et al. 2011

Saudi J Gastroenterol

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Background/Aim:Microscopic colitis (MC) is diagnosed when a patient with chronic watery non-bloody diarrhea (CWND) has an endoscopically normal colon, but colonic biopsies show unique inflammatory changes characteristic of lymphocytic or collagenous colitis. MC is a disorder of unknown etiology. Studies comparing the prevalence of the disease in developing countries as compared to developed countries may shed more light on the possibility of a post-infectious etiology. Most data on the incidence and prevalence of MC are from developed countries where it accounts for 4-13% of cases of CWND. There are only a few reports from developing countries. Two studies from Peru and Tunis, with high prevalence of infectious gastroenteritis, revealed MC in 40% and 29.3% of cases of CWND, respectively. The aim of this study was to investigate the prevalence of MC in patients presenting with CWND in Egypt.Materials and Methods:A total of 44 patients with CWND of unexplained etiology who had undergone full colonoscopy with no macroscopic abnormalities between January 2000 and January 2010 were assessed retrospectively.Results:The histological appearance of MC was identified in 22 (50%) patients. Twelve (55%) patients were male and 10 (45%) female. Mean age was 40 years (range: 20-65 years). Twenty (91%) of MC cases had lymphocytic colitis and 2 (9%) had collagenous colitis.Conclusions:The prevalence of MC in Egyptian patients with CWND is high when compared to that in developed countries. MC mainly affects young and middle-aged patients and it is more commonly of the lymphocytic type.

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Section: Discussionsupporting

confidence: 83%

“…[2] The female to male ratio is reported to be 5:1 in Iceland and 2:1 in Sweden. [912] In our study, MC mainly affects younger patients (50% of patients were aged less than 40 years), and there was a male predominance (male:female = 3:2.5).…”

Section: Discussionmentioning

confidence: 65%

Prevalence of microscopic colitis in patients with chronic diarrhea in Egypt: A single-center study

Gado

Ebeid

Hindawi

et al. 2011

Saudi J Gastroenterol

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“…9 The explanation for the association with female gender reported in most studies is likely multifactorial, including possible hormonal contributions, the increased likelihood of women developing autoimmune processes, and greater likelihood of females presenting to a physician to investigate chronic diarrhea. 3,6 …”

Section: Discussionmentioning

confidence: 99%

“…2–8 In a North American study of Olmsted County residents between 1985 and 2001, there was a significant increase in the incidence of MC and both subtypes over the study period, as well as a higher prevalence than had been reported previously, 103.0 per 100,000 persons overall for MC (39.3 for collagenous colitis and 63.7 for lymphocytic colitis). 2 Other studies have shown variable temporal trends, with some demonstrating an increase in the incidence of CC 3 or LC 4 over time, while another demonstrated stability in the incidence of CC. 9 …”

Section: Introductionmentioning

confidence: 99%

The Epidemiology of Microscopic Colitis in Olmsted County From 2002 to 2010: A Population-Based Study

Gentile

Khanna

Loftus

et al. 2014

Clinical Gastroenterology and Hepatology

101

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Background & Aims The increasing incidence of microscopic colitis has been partly attributed to diagnostic detection bias. We aimed to ascertain recent incidence trends and the overall prevalence of microscopic colitis in a population-based study. Methods Using data from the Rochester Epidemiology Project, we identified residents of Olmsted County, Minnesota who were diagnosed with collagenous colitis or lymphocytic colitis from January 1, 2002 through December 31, 2010 based on biopsy results and the presence of diarrhea (n=182; mean age at diagnosis, 65.8 y; 76.4% female). Poisson regression analyses were performed to evaluate associations between incidence and age, sex, and calendar period. Results The age- and sex-adjusted incidence of microscopic colitis was 21.0 cases per 100,000 person-years (95% confidence interval [CI], 18.0–24.1 cases per 100,000 person-years). The incidence of lymphocytic colitis was 12.0 per 100,000 person-years (95% CI, 9.6–14.3 per 100,000 person-years) and collagenous colitis was 9.1 per 100,000 person-years (95% CI, 7.0–11.1 per 100,000 person-years). The incidence of microscopic colitis and its subtypes remained stable over the study period (p=.63). Increasing age (p<.001) and female sex (p<.001) were associated with increasing incidence. On December 31, 2010, the prevalence of microscopic colitis was 219 cases per 100,000 persons (90.4 per 100,000 persons for collagenous colitis and 128.6 per 100,000 persons for lymphocytic colitis). Conclusion The incidence of microscopic colitis in Olmsted County residents has stabilized and remains associated with female sex and increasing age.

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“…Adults typically present with LC or CC, while children with CCC (a form of microscopic colitis characterized by the presence of various large mononuclear clear cells in lamina propria) (Bryant et al, 1996). Microscopic colitis (MC) represents 4% to 13% of cases in a population cohort with non-bloody diarrhea of unknown origin (Agnarsdottir et al, 2002; Bohr et al, 1995, 1996b; Fernandez-Banares et al, 1999; Olesen et al, 2004; Pardi et al, 2002b). …”

Section: Introductionmentioning

confidence: 99%

The various faces of autoimmune endocrinopathies: Non-tumoral hypergastrinemia in a patient with lymphocytic colitis and chronic autoimmune gastritis

Melcescu

Hogan²,

Brown³

et al. 2012

Experimental and Molecular Pathology

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Serum gastrin levels exceeding 1000 pg/ml (normal, <100) usually raise the suspicion for a neuroendocrine tumor (NET) that secretes gastrin. Rarely, such elevated gastrin levels are seen in patients with pernicious anemia which most commonly is associated with autoimmune gastritis (AG). AG can occur concomitantly with other autoimmune disorders including lymphocytic colitis (LC). Gastrin stimulates enterochromaffin-like cells which increase histamine secretion. Histamine excess can cause diarrhea as can bacterial overgrowth or LC. We present a 57-year-old woman with diarrhea, sporadic epigastric pain, and bloating. She also had a history of interstitial cystitis and took pentosan polysulfate and cetirizine. She had no history of ulcers, renal impairment or carcinoid syndrome. Fasting serum gastrin was 1846 pg/ml. Esophagoduodenal gastroscopy and biopsies revealed chronic gastritis and a pH of 7 with low stomach acid. Serum gastrin and plasma chromogranin A were suggestive of a gastrinoma or NET. Pernicious anemia was unlikely. Imaging studies did not reveal any tumor. Random colonic biopsy was compatible with LC, possibly explaining her diarrhea, although we also considered excessive histamine from elevated gastrin, bacterial overgrowth, and pentosan polysulfate which can cause diarrhea and be misleading in this setting, pointing to the diagnosis of gastrinoma. At 4 year follow-up in 2012, fasting serum gastrin was 1097 pg/ml and the patient asymptomatic taking only cetirizine for nasal allergies. This case illustrates that diarrhea may be associated with very high serum gastrin levels in the setting of chronic gastritis, LC, and interstitial cystitis (pentosan use), without clear evidence for a gastrinoma or NET. If no history of ulcers or liver metastases is present in such cases, watchful observation rather than an extensive/invasive and costly search for a NET may be justified. Considering the various forms of polyglandular syndrome, this may represent a variant and we here provide an algorithm for working up such patients, while also reviewing literature on the intertwined relationship between the immune and endocrine systems.

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Cited by 121 publications

References 12 publications

Prevalence of microscopic colitis in patients with chronic diarrhea in Egypt: A single-center study

Prevalence of microscopic colitis in patients with chronic diarrhea in Egypt: A single-center study

The Epidemiology of Microscopic Colitis in Olmsted County From 2002 to 2010: A Population-Based Study

The various faces of autoimmune endocrinopathies: Non-tumoral hypergastrinemia in a patient with lymphocytic colitis and chronic autoimmune gastritis

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