Lymphocytic colitis: clinical presentation and long term course

Müllhaupt, Beat; Güller, Ulrich; Anabitarte, M; Güller, R; Fried, M.

doi:10.1136/gut.43.5.629

Cited by 122 publications

(89 citation statements)

References 18 publications

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“…Tables 3 and 4 show that no overall significant differences in symptoms were observed between the first (either the previous or the diagnostic) and the second (either the diagnostic or the follow-up) procedure (P40.05 with sign rank test). In the two series of longitudinal studies of CC and LC patients cited earlier, 6,7 even in patients with histological regression, the symptoms did not subside concomitantly in all the patients.…”

Section: Discussionmentioning

confidence: 99%

“…Although sequential histological evaluations and follow-up of clinical presentations have been reported for collagenous colitis 6 and lymphocytic colitis, 7 the relationship between changes in symptoms and histological findings, as well as the relationship between changes in symptoms and histological findings with treatment, is still undetermined. Our study included both patients with biopsies before the diagnosis of microscopic colitis was established and patients with follow-up biopsies after the diagnosis was made.…”

Section: Discussionmentioning

confidence: 99%

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Sequential clinical and histopathological changes in collagenous and lymphocytic colitis over time

et al. 2004

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We conducted this retrospective study to evaluate the relationship between symptoms, histological findings, and treatment of collagenous (CC) and lymphocytic colitis (LC). We identified 19 CC and 12 LC patients having multiple colonoscopic procedures with colonic biopsies during their course of illness. A detailed histological review of all biopsies was performed. Clinical history, including symptoms and medications, was obtained in 25 of the 31 patients and was correlated with their histological findings. In all, 25% of the CC patients and 50% of the LC patients who had biopsies prior to their definitive diagnosis had the pathognomonic histological features on their prior biopsies to some extent (but were not recognized by the pathologists); however, these features were more pronounced on the biopsies from the procedure that established the diagnosis. Nonetheless, 10 of 12 such patients with clinical data available had symptoms and were being treated at the time of prior biopsies. Assessment of the relationship among histological, clinical and therapeutic data showed no association between symptoms or histological findings and treatment with any medication. In summary, in this sample of CC and LC patients, symptoms often precede fully developed histological features. No change in symptoms or histological findings was found to be associated with medication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sequential clinical and histopathological changes in collagenous and lymphocytic colitis over time

et al. 2004

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“…In a follow-up study of CC, 63% of the patients had a lasting remission after 3.5 years, and in another cohort study, all 25 patients were improved 47 mo after diagnosis, and only 29% of them required ongoing medication [107,108] . A benign course was reported in 27 cases with LC, with resolution of diarrhea and normalization of histology in > 80% of patients within 38 mo [109] . Others have reported that 63% of patients with LC had a single attack, with a median duration from onset of symptoms to remission of 6 mo [20] .…”

Section: Therapy and Prognosismentioning

confidence: 99%

Diagnosis and management of microscopic colitis

Tysk¹,

Bohr²,

Nyhlin³

et al. 2008

WJG

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Microscopic colitis, comprising collagenous and lymphocytic colitis, is characterized clinically by chronic watery diarrhea, and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination. The annual incidence of each disorder is 4-6/100 000 inhabitants, with a peak incidence in 60-70-year-old individuals and a noticeable female predominance for collagenous colitis. The etiology is unknown. Chronic diarrhea, abdominal pain, weight loss, fatigue and fecal incontinence are common symptoms, which impair the health-related quality of life of the patient. There is an association with other autoimmune disorders such as celiac disease, diabetes mellitus, thyroid disorders and arthritis. Budesonide is the best-documented shortterm treatment, but the optimal long-term strategy needs further study. The long-term prognosis is good and the risk of complications including colonic cancer is low.

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“…Clinical and histological characteristics of microscopic colitis have been well established [4][5][6][7][8] . However, limited data is available regarding the prevalence, pathogenesis and progress of the disease and its treatment.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of microscopic colitis in patients with diarrhea of unknown etiology in Turkey

Erdem¹,

Yıldırım²,

Akbayir³

et al. 2008

WJG

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AIM:To investigate the prevalence and demography of microscopic colitis in patients with diarrhea of unknown etiology and normal colonoscopy in Turkey. METHODS: Between March, 1998 to July, 2005, 129 patients with chronic non-bloody diarrhea of unexplained etiology who had undergone full colonoscopy with no obvious abnormalities were included in the study. Two biopsies were obtained from all colonic segments and terminal ileum for diagnosis of microscopic colitis. On histopathologic examination, c r i t e r i a fo r l y m p ho c y t ic c o l i t is ( int ra e p i t he l ia l lymphocyte ≥ 20 per 100 intercryptal epithelial cells, change in surface epithelium, mononuclear infiltration of t he lamina propria) and col lagenous coli tis (subepithelial collagen band thickness ≥ 10 µm) were explored. RESULTS: Lymphocytic colitis was diagnosed in 12 (9%) patients (Female/Male: 7/5, mean age: 45 year, range: 27-63) and collagenous colitis was diagnosed in only 3 (2.5%) patients (all female, mean age: 60 years, range: 54-65). CONCLUSION:Biopsy of Turkish patients with the diagnosis of chronic non-bloody diarrhea of unexplained etiology and normal colonoscopic findings will reveal microscopic colitis in approximately 10% of the patients. Lymphocytic colitis is 4 times more frequent than collagenous colitis in these patients.

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Lymphocytic colitis: clinical presentation and long term course

Cited by 122 publications

References 18 publications

Sequential clinical and histopathological changes in collagenous and lymphocytic colitis over time

Sequential clinical and histopathological changes in collagenous and lymphocytic colitis over time

Diagnosis and management of microscopic colitis

Prevalence of microscopic colitis in patients with diarrhea of unknown etiology in Turkey

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