Frequency and clinical evolution of indeterminate colitis: A retrospective multicenter study in northern Italy

Meucci, G.; Bortoli, A.; Albini, Fabio; Girelli, C.M.; Radaelli, Franco; Rivolta, R.; Tatarella, M.

doi:10.1016/s0016-5085(98)84225-x

Cited by 37 publications

(49 citation statements)

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“…It was reported that approximately 80% of IBDU cases were ultimately reclassified as either UC or CD within eight years of follow-up (Meucci et al, 1999). There is now good evidence that the majority of IBDU diagnoses are likely to behave as unusual examples of UC, with only 10%-40% of them ultimately proving to be CD (Yantiss and Odze, 2006).…”

Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease unclassified

Zhou

Chen

et al. 2011

J. Zhejiang Univ. Sci. B

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Abstract:Objective: Inflammatory bowel diseases (IBDs) are idiopathic, chronic, and inflammatory intestinal disorders. The two main types, ulcerative colitis (UC) and Crohn's disease (CD), sometimes mimic each other and are not readily distinguishable. The purpose of this study was to present a series of hospitalized cases, which could not initially be classified as a subtype of IBD, and to try to note roles of the terms indeterminate colitis (IC) and inflammatory bowel disease unclassified (IBDU) when such a dilemma arises. Methods: Medical records of 477 patients hospitalized due to IBD, during the period of January 2002 to April 2009, were retrospectively studied in the present paper. All available previous biopsies from endoscopies of these patients were reanalyzed. Results: Twenty-seven of 477 IBD patients (5.7%) had been initially diagnosed as having IBDU. Of them, 23 received colonoscopy and histological examinations in our hospital. A total of 90% (9/10) and 66.7% (4/6) of patients, respectively, had a positive finding via wireless capsule endoscopy (CE) and double-balloon enteroscopy (DBE). The barium-swallow or small bowel follow-through (SBFT) was performed on 11 patients. Positive changes were observed under computer tomographic (CT) scanning in 89.5% (17/19) of patients. Reasonable treatment strategies were employed for all patients. Conclusions: Our data indicate that IBDU accounts for 5.7% of initial diagnoses of IBD. The definition of IBDU is valuable in clinical practice. For those who had no clear clinical, endoscopic, histological, or other features affording a diagnosis of either UC or CD, IBDU could be used parenthetically.

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Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease unclassified

Zhou

Chen

et al. 2011

J. Zhejiang Univ. Sci. B

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“…1 While most of inflammatory bowel disease cases are further classified into either ulcerative colitis or Crohns disease, 5-10% of inflammatory bowel disease patients bear equivocal features, falling into the category of indeterminate colitis. [2][3][4] According to the World Congress of Gastroenterology Montreal Recommendations, 5 the diagnosis of indeterminate inflammatory bowel disease should be made only after colectomy, in cases where definitive features of Crohns disease and ulcerative colitis are absent. Although the nature of disease of most indeterminate inflammatory bowel disease patients becomes evident over time, a portion of patients remain indeterminate.…”

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confidence: 99%

MicroRNA expression patterns in indeterminate inflammatory bowel disease

Cao

Zhang

et al. 2013

Modern Pathology

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“…This study also further emphasizes that in the majority of IC patients, after careful analysis, a diagnosis of UC is usually favored. Finally, in one study by Meucci et al, 118 50 of 1113 IBD patients were diagnosed with IC (4.6%) clinically (before surgical resection). Upon follow-up, 73% of the IC patients had a definitive diagnosis of either UC or CD established (54% UC and 46% CD).…”

Section: Outcome Of Patients With Icmentioning

confidence: 98%

A contemporary and critical appraisal of ‘indeterminate colitis‘

Odze

2015

Modern Pathology

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Distinguishing ulcerative colitis (UC) from Crohn's disease (CD) is normally based on evaluation of a variety of clinical, radiologic, serologic and pathologic findings, the latter in biopsy and/or resection specimens. Unfortunately, some patients with IBD show overlapping pathologic features of UC and CD, which makes definite distinction between these two disorders difficult or even impossible. In most instances of uncertainty, the patient shows clinical and pathologic features of UC, but in addition, the patient's colon resection specimen reveals one or more CD-like features. In this setting, a diagnosis of indeterminate colitis (IC) is often rendered. IC is not a distinct disease entity, and, thus, it has no diagnostic criteria. The most common causes of uncertainty in IBD pathology that may lead to a diagnosis of IC in a colon resection specimen includes the presence of fulminant (severe and toxic) colitis, insufficient radiologic, endoscopic, or pathologic information (including analysis of prior biopsies) on the patient, failure to utilize major diagnostic criteria as hard evidence in favor of CD, failure to recognize unusual variants of UC and CD that may mimic each other, failure to recognize non-IBD mimics and other superimposed diseases that cause unusual pathologic features in a resection specimen, an attempt to distinguish UC from CD in mucosal biopsies of the colon and ileum, or an attempt to change the patients diagnosis (of UC or CD) based on pouch or diversion-related complications. Details of each of these causes of uncertainty are discussed, in detail, in this review article. A diagnosis of IC should never be made clinically or by pathologists based on evaluation of pre-resection colonic mucosal biopsies. Ultimately, the majority of indeterminate cases represent UC, and, thus, most of these patient can be treated safely with a colectomy combined with an ileal pouch anal anastomosis procedure.

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Frequency and clinical evolution of indeterminate colitis: A retrospective multicenter study in northern Italy

Cited by 37 publications

References 0 publications

Inflammatory bowel disease unclassified

Inflammatory bowel disease unclassified

MicroRNA expression patterns in indeterminate inflammatory bowel disease

A contemporary and critical appraisal of ‘indeterminate colitis‘

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