scholarly journals Incidence and Prevalence of Microscopic Colitis Between 2001 and 2016: A Danish Nationwide Cohort Study

2020 ◽  
Vol 14 (12) ◽  
pp. 1717-1723
Author(s):  
Petra Weimers ◽  
Dorit Vedel Ankersen ◽  
Søren Lophaven ◽  
Ole Kristian Bonderup ◽  
Andreas Münch ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cohort Study ◽  
Regional Differences ◽  
Collagenous Colitis ◽  
Epidemiological Studies ◽  
Microscopic Colitis ◽  
Lymphocytic Colitis ◽  
The Past ◽  
Populated Region ◽  
Recorded Diagnosis

Abstract Background and Aims Epidemiological studies suggest an increasing global incidence of microscopic colitis, including collagenous colitis and lymphocytic colitis. We aimed to investigate the incidence and prevalence of microscopic colitis in Denmark. Methods In a nationwide cohort study, we included all incident patients with a recorded diagnosis of collagenous colitis or lymphocytic colitis in the Danish Pathology Register between 2001 and 2016. Results A total of 14 302 patients with microscopic colitis—8437 [59%] with collagenous and 5865 [41%] with lymphocytic colitis—were identified during the study period. The prevalence in December 2016 was estimated to be 197.9 cases per 100 000 inhabitants. Microscopic colitis was more prevalent among females (n = 10 127 [71%]), with a mean annual incidence of 28.8, compared with 12.3 per 100 000 person-years among males. The overall mean incidence during the study period was 20.7 per 100 000 person-years. Mean age at time of diagnosis was 65 years (standard deviation [SD]:14) for microscopic colitis, 67 [SD:13] for collagenous colitis, and 63 [SD:15] for lymphocytic colitis. The overall incidence increased significantly from 2.3 cases in 2001 to 24.3 cases per 100 000 person-years in 2016. However, the highest observed incidence of microscopic colitis was 32.3 cases per 100 000 person-years in 2011. Large regional differences were found, with the highest incidence observed in the least populated region. Conclusions The incidence of microscopic colitis in Denmark has increased 10-fold during the past 15 years and has now surpassed that of Crohn’s disease and ulcerative colitis. However, incidence has stabilised since 2012, suggesting that a plateau has been reached.

scholarly journals Familial Microscopic Colitis

2001 ◽  
Vol 15 (5) ◽  
pp. 341-343 ◽  
Author(s):  
Ayman Assad Abdo ◽  
Peter Jeffrey Zetler ◽  
Lawrence S Halparin
Keyword(s):  
Chronic Diarrhea ◽  
Present Report ◽  
Disease Process ◽  
Collagenous Colitis ◽  
Microscopic Colitis ◽  
Familial Occurrence ◽  
Lymphocytic Colitis ◽  
The Third ◽  
Inflammatory Conditions ◽  
Colonic Biopsy

Collagenous and lymphocytic colitis are two inflammatory conditions of the colon that are often collectively referred to as microscopic colitis. The present report describes what is believed to be the third published case of familial microscopic colitis. A 55-year-old woman who suffered from chronic diarrhea was diagnosed with lymphocytic colitis on colonic biopsy. Subsequently, her 36-year-old daughter was diagnosed with collagenous colitis. The familial occurrence of these diseases may support an immunological hypothesis for their etiology. In addition, it supports the assumption that collagenous and lymphocytic colitis are two manifestations of the same disease process rather than two completely separate entities. The familial tendency of this disease may make a case for early colonoscopy and biopsy in relatives of patients diagnosed with microscopic colitis if they present with suggestive symptoms.

scholarly journals Colectomy Rates for Ulcerative Colitis Differ between Ethnic Groups: Results from a 15-Year Nationwide Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ravi Misra ◽  
Alan Askari ◽  
Omar Faiz ◽  
Naila Arebi
Keyword(s):  
Ulcerative Colitis ◽  
Cohort Study ◽  
South Asians ◽  
Epidemiological Studies ◽  
Hospital Episode Statistics ◽  
Confounding Factors ◽  
Diagnosis Code ◽  
Administrative Dataset ◽  
Significant Difference ◽  
Icd 10

Introduction. Previous epidemiological studies suggest a higher rate of pancolonic disease in South Asians (SA) compared with White Europeans (WE). The aim of the study was to compare colectomy rates for ulcerative colitis (UC) in SA to those of WE.Methods. Patients with UC were identified from a national administrative dataset (Hospital Episode Statistics, HES) between 1997 and 2012 according to ICD-10 diagnosis code K51 for UC. The colectomy rate for each ethnic group was calculated as the proportion of patients who underwent colectomy from the total UC cases for that group.Results. Of 212,430 UC cases, 73,318 (35.3%) were coded for ethnicity. There was no significant difference in the colectomy rate between SA and WE (6.93% versus 6.90%). Indians had a significantly higher colectomy rate than WE (9.8% versus 6.9%,p<0.001). Indian patients were 21% more likely to require colectomy for UC compared with WE group (OR: 1.21, 95% CI: 1.04–1.42, andp=0.001).Conclusions. Given the limitations in coding, the colectomy rate in this cohort was higher in Indians compared to WE. A prospectively recruited ethnic cohort study will decipher whether this reflects a more aggressive phenotype or is due to other confounding factors.

scholarly journals Perinuclear Antineutrophil Cytoplasmic Antibodies in Collagenous or Lymphocytic Colitis with or without Celiac Disease

1997 ◽  
Vol 11 (5) ◽  
pp. 417-420 ◽  
Author(s):  
Hugh James Freeman
Keyword(s):  
Ulcerative Colitis ◽  
Risk Factor ◽  
Celiac Disease ◽  
Sclerosing Cholangitis ◽  
Collagenous Colitis ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Lymphocytic Colitis ◽  
Heterogeneous Nature ◽  
Assay Result ◽  
First Time

Microscopic forms of colitis, including lymphocytic and collagenous colitis, have been observed in both those with and without celiac disease. Although perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) occur in most patients with ulcerative colitis, investigations in microscopic, particularly lymphocytic, colitis are still needed. In this study atypical p-ANCA was evaluated in 55 patients, including 27 with celiac disease alone, 13 with celiac disease and concomitant lymphocytic colitis, and 15 with microscopic forms of colitis, including lymphocytic and collagenous colitis. Nine patients (16.3%) had atypical p-ANCA, including six with celiac disease and three with a microscopic form of colitis alone. Although five of the six positive celiac disease patients had lymphocytic colitis, all three celiac disease patients with associated primary sclerosing cholangitis - a separate risk factor for a positive assay result - were serologically positive for atypical p-ANCA. These results indicate for the first time that this serological marker may occur in histologically defined celiac disease with or without concomitant lymphocytic colitis. Furthermore, these results suggest that the pathogenesis of ulcerative colitis differs from that of lymphocytic colitis and further emphasizes the heterogeneous nature of these newly recognized types of colonic inflammatory mucosal disorders.

The Behavior of Matrix Metalloproteinase-9 in Lymphocytic Colitis, Collagenous Colitis and Ulcerative Colitis

2011 ◽  
Vol 18 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Gábor Lakatos ◽  
Ferenc Sipos ◽  
Pál Miheller ◽  
István Hritz ◽  
Mária Zsófia Varga ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Matrix Metalloproteinase ◽  
Collagenous Colitis ◽  
Matrix Metalloproteinase 9 ◽  
Lymphocytic Colitis ◽  
Metalloproteinase 9

scholarly journals A196 MORE MICROSCOPIC THAN WAS THOUGHT: A RARE CASE OF ISOLATED LYMPHOCYTIC ILEITIS WITHOUT MICROSCOPIC COLITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 219-220
Author(s):  
K S Singh ◽  
R Yanofsky ◽  
D Haegert ◽  
Z Gao ◽  
T Bessissow
Keyword(s):  
Terminal Ileum ◽  
Oral Intake ◽  
Collagenous Colitis ◽  
Lymphocytic Infiltration ◽  
Chronic Inflammatory Disease ◽  
Microscopic Colitis ◽  
Lymphocytic Colitis ◽  
Colonic Disease ◽  
Normal Colonic Mucosa ◽  
Macroscopic Appearance

Abstract Background Microscopic colitis (MC) is a chronic inflammatory disease of the colon characterized by lymphocytic infiltration with (collagenous colitis) or without (lymphocytic colitis) the expansion of collagen fibres, and the normal macroscopic appearance of the mucosa on ileocolonoscopy. Recent studies have shown that the ileum may be involved in MC, occurring concurrently with colonic disease, however there is sparse literature on isolated lymphocytic ileitis without colitis. Aims We describe the case of isolated small bowel lymphocytosis without evidence of lymphocytic colitis to highlight the utility of random biopsies of the terminal ileum in cases where microscopic colitis is a diagnostic consideration. Methods A 70-year-old female known for cutaneous mastocytosis presented with six weeks of abdominal pain, non-bloody diarrhea, intolerance to oral intake and significant weight loss. Computed-tomography showed evidence of possible mesenteric panniculitis. Colonoscopy revealed a normal colon and normal-appearing mucosa of the terminal ileum. Random mucosal biopsies were taken to assess for microscopic colitis, with terminal ileal biopsies revealing significant lymphocytic infiltration consistent with lymphocytic ileitis. Biopsies throughout the colon revealed normal colonic mucosa without evidence of concurrent microscopic colitis. Gastroscopy was macroscopically unremarkable and random biopsies in the stomach and duodenum were negative for Helicobacter pylori and lymphocytosis. Immunostaining of the gastric, duodenal, terminal ileal and colonic biopsy specimens were negative for CD25, CD117 and tryptase, indicating the absence of gastrointestinal mastocytosis. Results The patient was diagnosed with lymphocytic ileitis and given the known response of MC to budesonide, she was treated with eight weeks of budesonide with clinical improvement leading to remission of her symptoms. Conclusions This case illustrates a rare incidence of isolated ileal microscopic ileitis without colitis that responded well to standard MC treatment, thereby underscoring the utility of random biopsies in the terminal ileum and throughout the colon when microscopic colitis is on the differential diagnosis. Funding Agencies None

High risk of microscopic colitis after Campylobacter concisus infection: population-based cohort study

Gut ◽  
2020 ◽  
Vol 69 (11) ◽  
pp. 1952-1958 ◽  
Author(s):  
Hans Linde Nielsen ◽  
Michael Dalager-Pedersen ◽  
Henrik Nielsen
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Collagenous Colitis ◽  
Population Based ◽  
Stool Culture ◽  
Microscopic Colitis ◽  
Campylobacter Concisus ◽  
Positive Stool ◽  
Population Comparisons ◽  
Culture Negative

ObjectiveMicroscopic colitis (MC) encompasses the two histopathological distinct entities of collagenous colitis (CC) and lymphocytic colitis (LC). In this Danish population-based cohort study, we examined the risk of MC following stool culture with Campylobacter concisus, C. jejuni, non-typhoidal Salmonella or a culture-negative stool test.DesignWe identified patients with a first-time positive stool culture with C. concisus, C. jejuni, non-typhoidal Salmonella or negative stool test, from 2009 through 2013 in North Denmark Region, Denmark, and matched each with 10 population comparisons. All subjects were followed up until 1 March 2018 using Systematised Nomenclature of Medicine codes from The Danish Pathology Register for incident diagnoses of CC and LC. We computed risk and adjusted HRs with 95% CIs for MC among patients and comparisons.ResultsWe identified 962 patients with C. concisus, 1725 with C. jejuni, 446 with Salmonella and 11 825 patients with culture-negative stools. The MC risk and HR versus comparisons were high for patients with C. concisus (risk 6.2%, HR 32.4 (95% CI 18.9 to 55.6)), less for C. jejuni (risk 0.6%, HR 3.7 (95% CI 1.8 to 7.7)), low for Salmonella (risk 0.4%, HR 2.2 (95% CI 0.5 to 10.8)) and for patients with negative stool testing (risk 3.3%, HR 19.6 (95% CI 16.4 to 23.4)). After exclusion of the first year of follow-up, the HRs were 9.3 (95% CI 4.1 to 20.1), 2.2 (95% CI 0.9 to 5.4), 1.3 (95% CI 0.2 to 11.1) and 5.6 (95% CI 4.6 to 7.2), respectively.ConclusionA high risk of MC was observed following C. concisus in stools. Further studies are needed to elucidate any underlying biological mechanisms.

scholarly journals Microscopic Colitis- Its Prevalence and Characteristics in Diarrhoea Predominant Irritable Bowel Syndrome- A Study of 100 Cases

2016 ◽  
Vol 12 (1) ◽  
pp. 57-62
Author(s):  
SM Mizanur Rahman ◽  
SM Motahar Hossain ◽  
Niamul Gani Chowdhury ◽  
Md Delwar Hossain ◽  
Jakeya Rashid
Keyword(s):  
Irritable Bowel Syndrome ◽  
Collagenous Colitis ◽  
Microscopic Colitis ◽  
Lymphocytic Colitis ◽  
Military Hospital ◽  
Elderly Persons ◽  
Rome Iii Criteria ◽  
Chronic Inflammatory Condition ◽  
Rome Iii ◽  
Irritable Bowel

Introduction: Irritable bowel Syndrome (IBS) is a functional disorder of abdominal pain or discomfort associated with altered bowel habit. Microscopic colitis is a chronic inflammatory condition associated with non bloody diarrhoea and characteristic histological finding. The subset of diarrhoea predominant IBS is having similarity in presentation with microscopic colitis. Objective: To assess the prevalence and characteristics of microscopic colitis in Diarrhoea predominant Irritable Bowel Syndrome (IBS-D). Materials and Methods: This observational study was conducted at the department of Gastroenterology, Combined Military Hospital, Dhaka during the period of January 2011 to June 2011. Initially 100 cases of diarrhoea predominant IBS who met Rome III criteria were included. Among those 100 cases, 57 were male and 43 were female. Mean age was 46 years ±2.8 SD(range 18-72). Six patients were subsequently excluded because of some macroscopic abnormalities at colonoscopy. Finally 94 patients of clinical IBS-D whose colonoscopy were normal, biopsy specimens were taken from caecum, transverse colon, descending colon, sigmoid and rectum. Microscopic colitis was diagnosed on the basis of evidence of increased intraepithelial lymphocytes of ≥20/100 inter cryptal epithelial cells and infiltration of lamina propria by mixed inflammatory cells. Overlap of other symptoms between Microscopic Colitis (MC) and IBS-D were also evaluated. Results: Among the 94 patients of clinical IBS-D, 23(24%) patients were histologically proved to have microscopic colitis. Besides Rome III criteria, there was significant overlap of other symptoms. Occasional fever and infrequent arthralgia 7% and 26% vs 4% respectively) but tenesmus, passage of excessive mucus and heart- burn were more prevalent in IBS-D than MC (35% vs 13%, 32% vs 4% and 32 vs 9% respectively). Among the 23 cases of MC, 13(57%) patients were female and 10(43%) patients were male. Mean age of microscopic colitis was 56 years ±2.6 SD (range 25-72). Regarding subtypes of microscopic colitis, 21(91%) patients had lymphocytic colitis (LC) and 2 (9%) patients had collagenous colitis (CC). Of the lymphocytic colitis 11 were female and 10 were male and of the 02 cases of collagenous colitis all were female. MC affected mostly the transverse colonie 11(48%) cases and the next common site was caecum ie 8(35%) cases. Conclusion: A good percentage of diarrhoea predominant IBS are actually having microscopic colitis. MC is more common in female and elderly persons. In all elderly patients of IBS-D full colonoscopy should be done and biopsy should be taken from multiple sites to exclude microscopic colitis. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 57-62

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