Lymphocytic colitis: clinical features, treatment, and outcomes

Pardi, Darrell S.; Ramnath, Venktesh R.; Loftus, Edward V.; Tremaine, William J.; Sandborn, William J.

doi:10.1111/j.1572-0241.2002.07030.x

Cited by 144 publications

(125 citation statements)

References 13 publications

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“…Limitations of this study included limited information on over-the-counter medication usage, particularly nonsteroidal anti-inflammatory drugs (NSAIDs), which have been reported in 34-71% of patients with either LC or CC in published studies [18,[48][49][50]. Despite the lack of robust or consistent data, it is generally thought that NSAIDs probably play some role in the pathogenesis of MC, mostly based on case reports describing changes in diarrhea and histology with NSAID use and withdrawal [51].…”

Section: Discussionmentioning

confidence: 96%

“…This initially yielded 724 patients with a pathology report suggestive of MC during that period. Of these cases, 124 (approx 1 in every 5) were randomly selected for review by an expert GI pathologist (CH) to confirm the diagnosis of MC, based on previously published criteria for LC and CC [18][19][20][21]. We defined CC histologically to be the following: thickness of the collagenous subepithelial table [10 lm using an ocular micrometer, inflammation in the lamina propria consisting of mainly lymphocytes and plasma cells, lack of crypt architectural distortion, and regenerative-appearing changes in the surface and/or crypt epithelium.…”

Section: Inclusion Criteria For Microscopic Colitismentioning

confidence: 99%

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Decreased Colorectal Cancer and Adenoma Risk in Patients with Microscopic Colitis

et al. 2011

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Section: Discussionmentioning

confidence: 96%

Section: Inclusion Criteria For Microscopic Colitismentioning

confidence: 99%

Decreased Colorectal Cancer and Adenoma Risk in Patients with Microscopic Colitis

et al. 2011

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“…There have been no prevalence studies of microscopic colitis reported from the Mayo Clinic. Pardi et al did report the clinical features in a cohort of 170 patients with biopsy-proven lymphocytic colitis, showing that 100% of these patients had diarrhea (23). However, the denominator (i.e., total number of patients with diarrhea undergoing biopsy) was not reported.…”

Section: Celiac Sprue Detectionmentioning

confidence: 93%

Economic Comparison of Current Endoscopic Practices: Barrett’s Surveillance vs. Ulcerative Colitis Surveillance vs. Biopsy for Sprue vs. Biopsy for Microscopic Colitis

Harewood

2004

Dig Dis Sci

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Health care costs are an increasingly important study outcome. Endoscopic practice consumes a large proportion of gastroenterology-related health expenses. An economic comparison of several currently accepted endoscopic practices was performed, ranking them according their cost-effectiveness, as viewed from the payer perspective. The cost-effectiveness of four currently accepted standard endoscopic practices was examined: small bowel biopsy to assess for celiac sprue, colonoscopic biopsy to assess for microscopic colitis, surveillance of Barrett's esophagus, and surveillance of chronic ulcerative colitis (CUC). Parameter estimates were obtained from the published literature. Charges were based on Medicare professional plus facility/technical fees. Performing colonoscopic biopsies for microscopic colitis in the setting of chronic nonbloody diarrhea was the most cost-effective practice ($2447/case detected), while small bowel biopsy for sprue in the setting of a patient with a first-degree relative with sprue ($3042/case detected) or with anemia ($2982/case detected) was also a cost-effective approach. Small bowel biopsy in the setting of diarrhea ($3900/case detected) was less cost-effective, while CUC surveillance ($14,119/detection of dysplasia) and performance of small bowel biopsy in an asymptomatic patient ($15,209/case detected) were clearly the least economical. As efforts are made to reduce the costs of health care, more attention will be focused on the cost-effectiveness of routine endoscopic practices. Although, our findings put endoscopic practices into economic perspective, future perspective, future prospective trials are required to confirm the validity of these findings.

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“…The peak incidence is around 65 years, but the age at onset can range between 10 and 90 years [4,6,7]. The peak onset for LC is comparable to that of CC, with similar age ranges, but here the female preponderance is less pronounced according to some studies [6,7,8,9]. …”

Section: Epidemiologymentioning

confidence: 96%

Microscopic Colitis

Bouma¹,

Münch²

2015

Dig Dis

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Microscopic colitis (MC) is the common denominator for lymphocytic and collagenous colitis (CC). It is now recognized as a relatively frequent cause of diarrhea that equals the prevalence of inflammatory bowel disease. Patients are typically middle-aged women, but disease may occur at every age. Patients with MC report watery, non-bloody diarrhea in the absence of endoscopic and radiologic abnormalities. Lymphocytic colitis is characterized by an increased number of intraepithelial lymphocytes, and CC by a thickened subepithelial collagen band, whereas in both an increased mononuclear infiltration of the lamina propria is found. The pathogenesis of MC is largely unknown, but may relate to autoimmunity, adverse reactions to drugs or (bacterial) toxins, and abnormal collagen metabolism in the case of CC. Budesonide is so far the only drug that has proven efficacy in randomized controlled trials both for the induction and maintenance of remission. Patients who are nonresponsive, dependent or who experience side effects on budesonide may benefit from thiopurine or anti-TNF treatment, but these options are still experimental. The long-term prognosis of MC is good; it does not appear to predispose to malignancies and can in some cases be self-limiting. Further research and randomized clinical trials are required to expand our understanding of the natural course and the pathogenesis of MC.

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Lymphocytic colitis: clinical features, treatment, and outcomes

Cited by 144 publications

References 13 publications

Decreased Colorectal Cancer and Adenoma Risk in Patients with Microscopic Colitis

Decreased Colorectal Cancer and Adenoma Risk in Patients with Microscopic Colitis

Economic Comparison of Current Endoscopic Practices: Barrett’s Surveillance vs. Ulcerative Colitis Surveillance vs. Biopsy for Sprue vs. Biopsy for Microscopic Colitis

Microscopic Colitis

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