The endoscopically normal colon: when is mapping biopsy histopathologically justifiable?: Table 1

Elliot, Victoria; Bateman, A C; Green, B

doi:10.1136/flgastro-2011-100023

Cited by 9 publications

(1 citation statement)

References 18 publications

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“…In one case, the distorted mucosal histological pattern was consistent with inflammatory bowel disease. Moreover, Elliot et al reported that, among 151 patients with endoscopically normal or near normal colorectal mucosa, 14% (8 patients) had abnormal colorectal histology and two of them had histological findings indicating inflammatory bowel disease, ulcerative colitis type [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine

Voukelatou

Sfendouraki

Karianos

et al. 2016

Case Reports in Medicine

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Background. The presence of ulcerative colitis (UC) with no bowel symptoms, as fever of unknown origin (FUO), is uncommon. Objective. To describe the case of an 80-year-old woman who presented with fever, with a history of UC under treatment with mesalazine. Case Presentation. She was admitted due to fever lasting for 12 days with no associated symptoms. Seven years earlier, she was diagnosed with UC. After an extended workup for FUO that failed to reach the diagnosis, she underwent a gallium-67 scintigraphy. This revealed a persistent diffuse concentration of gallium-67 in the ascending colon at 24-hour imaging that remained stable at 48- and 72-hour imaging without any topographic change after the use of laxatives. Considering the results and in the absence of another diagnosis, the patient was treated with 30 mg prednisone daily and mesalazine, as treatment of active UC. Subsequently, the patient's condition improved markedly and the fever retreated. One month later, she was reevaluated with a gallium-67 scintigraphy with total absence of gallium-67 concentration in the ascending colon. Conclusion. UC activity must be included in the differential diagnosis of FUO in patients with longstanding disease, since fever may present alone, with no other manifestations.

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Section: Discussionmentioning

confidence: 99%

Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine

Voukelatou

Sfendouraki

Karianos

et al. 2016

Case Reports in Medicine

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Biopsies From Ascending and Descending Colon Are Sufficient for Diagnosis of Microscopic Colitis

Virine

Chande

Driman

2020

Clinical Gastroenterology and Hepatology

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This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e107. Learning Objective-Upon completion of this activity, successful learners will be able to diagnose microscopic colitis in a resource efficient manner; recognize the limitations of regional sampling of the colon for microscopic colitis; understand the distribution of microscopic colitis in the colon; understand regional variations in collagenous and lymphocytic colitis. BACKGROUND & AIMS: Lymphocytic and collagenous colitis are types of microscopic colitis (MC) that commonly cause chronic watery diarrhea, but there are no macroscopic features of MC that can be detected during colonoscopy. Endoscopists therefore often collect multiple random colonic biopsies, potentially oversampling, increasing times of colonoscopy and slide review. We sought to identify sites from which biopsies could be taken and analyzed to identify patients with MC with a high level of sensitivity and determine the appropriate number of biopsies to take at these sites. METHODS: We performed a retrospective study using biopsies from 101 consecutive patients with MC (52 cases of collagenous colitis, 42 cases of lymphocytic colitis, 7 combined cases), without comorbidities, from 2017 through 2018. Slides were reviewed, and the proportion of biopsies that were diagnostic of MC were calculated at each biopsy site. RESULTS: The proportions of biopsy fragments from each site of the colon found to be positive for MC were as follows: cecum, 90.0%; ascending colon, 96.9%; hepatic flexure, 77.8%; transverse colon, 95.7%; splenic flexure, 75.0%; descending colon, 85.0%; sigmoid colon, 90.9%; and rectum, 82.2%. For biopsies labeled random, 95.7% were positive for MC. When findings from ascending and descending colon biopsies were combined, 100% of MC cases were detected. CONCLUSIONS: MC can be detected with certainty by analyzing biopsies from the ascending and descending colon. Fewer biopsies than were collected from our cases are sufficient for diagnosis. We propose a Western protocol (taking 2 biopsies from each of the ascending and descending colon) in evaluation of patients for MC.

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Diagnostic yield of random colon biopsy sampling in patients with chronic diarrhea and normal colonoscopy: a systematic review and meta-analysis

Loganathan

Mohan

Ramai

et al. 2023

iGIE

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The endoscopically normal colon: when is mapping biopsy histopathologically justifiable?: Table 1

Cited by 9 publications

References 18 publications

Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine

Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine

Biopsies From Ascending and Descending Colon Are Sufficient for Diagnosis of Microscopic Colitis

Diagnostic yield of random colon biopsy sampling in patients with chronic diarrhea and normal colonoscopy: a systematic review and meta-analysis

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