Contrasting Autoimmune Comorbidities in Microscopic Colitis and Inflammatory Bowel Diseases

Abstract

Background: Inflammatory bowel diseases (Crohn’s disease and ulcerative colitis) and microscopic colitis (lymphocytic and collagenous colitis) are immune-mediated diseases of the gastrointestinal tract, with distinct pathophysiology. Objective: We sought to compare the prevalence of autoimmune diseases between microscopic colitis (MC) and inflammatory bowel diseases (IBDs) in our patient cohorts in their medical history. Methods: We collected data from 611 patients (508 with IBD, 103 with MC). We recorded cases of other autoimmune diseases. The screened documentation was written in the period between 2008 and 2022. We sought to determine whether colonic involvement had an impact on the prevalence of autoimmune diseases. Results: Ulcerative colitis patients and patients with colonic-predominant Crohn’s disease had a greater propensity for autoimmune conditions across the disease course than patients with ileal-predominant Crohn’s disease. Gluten-related disorders were more common in Crohn’s disease than in ulcerative colitis, and slightly more common than in microscopic colitis. In ulcerative colitis, 10 patients had non-differentiated collagenosis registered, which can later develop into a definite autoimmune disease. Conclusions: Predominantly colonic involvement can be a predisposing factor for developing additional autoimmune disorders in IBD. Ulcerative colitis patients may have laboratory markers of autoimmunity, without fulfilling the diagnostic criteria for definitive autoimmune disorders (non-differentiated collagenosis).

Adult-Onset Still’s Disease (AOSD) Associated With Collagenous Colitis (CC) and Basedow’s Disease: A Case Report

“…As stated before, we did not find any connection between MC and AOSD, but our research revealed a possible link with Basedow’s disease. In an observational study, 75 patients with CC displayed concomitantly auto-immune disorders, most frequently Hashimoto thyroiditis, rheumatoid arthritis, lupus and Sjogren syndrome, while Basedow’s disease was reported in one case [ 22 ].…”

Acute Pancreatitis After Microscopic Colitis: Is It due to Drugs or Disease?

“…This, more restrictive, algorithm yielded only 9 events, all occurring in reference individuals, and thus, a hazard ratio could not be computed. We also note that Saini et al (4) recently published an article concluding that the purported APinducing effects of many medications rely on limited evidence. We agree that monitoring events after reintroduction of certain medications would be a worthwhile The American Journal of GASTROENTEROLOGY…”

“…Hence, regarding these comorbidities as time-varying covariates of AP risk may be preferable. Moreover, adjusting for other autoimmune diseases associated with AP (such as autoimmune pancreatitis, type 1 diabetes, and primary sclerosing cholangitis) as covariates would increase the reliability and credibility of the results (4).…”