scholarly journals Polypoid Collagenous Colitis: A Microscopic Colitis with a Macroscopic Appearance

2020 ◽  
pp. 36
Author(s):  
Keyword(s):  
Collagenous Colitis ◽  
Microscopic Colitis ◽  
Macroscopic Appearance

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

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 Case Report: Ramipril and microscopic colitis; a necessary tool of cardiologists can rarely be devastating for patients

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1113
Author(s):  
Saad Hasan ◽  
Haseeb Ur Rahman ◽  
Stephen Hutchison
Keyword(s):  
Case Report ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pancreatic Enzyme ◽  
Collagenous Colitis ◽  
Microscopic Colitis ◽  
Chronic Diarrhoea ◽  
Converting Enzyme Inhibitors ◽  
Enzyme Replacement ◽  
Pancreatic Enzyme Replacement Therapy

Angiotensin converting enzyme inhibitors could lead to severe diarrhoea related to microscopic colitis. Few of such cases have been reported before and this serious problem, from a widely used class of drugs in hypertension and heart failure, needs to be more recognised. We describe the case of collagenous colitis related to ramipril use in the following case report. A 74-year-old farmer who had a history of triple vessel coronary artery disease was admitted to district general hospital with non-ST elevation myocardial infarction. He had known alcohol-related chronic pancreatitis with chronic diarrhoea as a complication, which was managed with pancreatic enzyme replacement therapy. However, he developed severe worsening of diarrhoea causing bowel incontinence and nocturnal symptoms during his admission to hospital. The explosive and watery nature of diarrhoea with urgency was so troublesome that it delayed coronary revascularisation and lead him to have significant psychological distress and low mood while nocturnal bowel motions meant he was unable to sleep. He was compliant with his pancreatic enzyme replacement therapy during this period. Infective causes were ruled out by stool microbiology examination and coeliac disease by oesophagogastroscopy and biopsy. It was noticed that he was recently prescribed ramipril that was later stopped as a possible diarrhoea trigger. Diarrhoea started settling immediately and resolved to his baseline within a week. A colonoscopy was performed in the meantime and biopsies demonstrated microscopic colitis (MC). He did not tolerate budesonide well so was stopped. However, a follow-up colonoscopy with biopsy in two months showed resolution of MC.

scholarly journals Microscopic colitis: A literature review

2016 ◽  
Vol 62 (9) ◽  
pp. 895-900 ◽  
Author(s):  
ANA PAULA HAMER SOUSA CLARA ◽  
FLÁVIA DRAGO MAGNAGO ◽  
JULIANA NEVES FERREIRA ◽  
THAIS GAGNO GRILLO
Keyword(s):  
Scientific Evidence ◽  
Collagenous Colitis ◽  
Gastrointestinal Disorder ◽  
Normal Mucosa ◽  
Term Treatment ◽  
Diagnostic Methods ◽  
Microscopic Colitis ◽  
Older Individuals ◽  
Short Term Treatment ◽  
Pubmed Database

SUMMARY Microscopic colitis (MC) refers to chronic inflammation of the colon which is characterized by histologic changes at the level of a radiologically and endoscopically normal mucosa. It is a common cause of chronic non-bloody diarrhea that occurs primarily in older individuals; however, there are few studies in the literature with strong scientific evidence compared to other inflammatory bowel diseases (IBD), which limits the knowledge of physicians and pathologists. This article aims to review the information on MC, describing diagnostic methods and drugs available for treatment. We conducted a search of the Pubmed database and CAPES Portal using the keywords “microscopic colitis”, “collagenous colitis”, “lymphocytic colitis”, and “review” for selection of articles published between 1996 and 2015 related to the topic. Based on the studies discussed in this review, we conclude that MC is a relatively new gastrointestinal disorder, most studies are incipient particularly with respect to pathophysiology and immunology, and budesonide is the best documented short-term treatment. However, further studies are needed to elucidate the best strategy for treatment in the long term.

scholarly journals Increased Mast Cell Counts and Degranulation in Microscopic Colitis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Zhikai Chi ◽  
Jing Xu ◽  
Romil Saxena
Keyword(s):  
Mast Cell ◽  
Cell Count ◽  
Cell Activation ◽  
Collagenous Colitis ◽  
Microscopic Colitis ◽  
Mast Cell Activation ◽  
Mucosal Inflammation ◽  
High Power Field ◽  
Cell Counts ◽  
Mast Cell Count

Objectives. Microscopic colitis (MC) is characterized by chronic diarrhea, normal colonoscopy findings, and mucosal inflammation in colonic biopsies and can be classified as collagenous colitis (CC) or lymphocytic colitis (LC). However, the pathogenesis of MC is largely unknown. In this study, we aimed to study mast cell counts and activation in MC. Methods. We investigated 64 biopsy samples from the surgical pathology database of Indiana University Health, which met the diagnostic criteria for CC or LC along with 20 control samples collected from 2014 to 2015. The specimens were used for the quantification of mast cells by examining the presence of intracellular and extracellular tryptase by immunohistochemistry. Results. In the lamina propria, the mast cell count was higher in both CC and LC groups than the control (mean highest count, 39/high-power field (HPF) vs. 30/HPF vs. 23/HPF; P<0.01). Extracellular tryptase was present in 10% of control subjects as compared to 41% of CC (P<0.05) and 60% of LC (P<0.001) patients. When LC patients were stratified into two groups with either <80% or >80% of fragments affected by inflammation, increased mast cell counts are only observed in the >80% involvement group compared with the control, but not the <80% involvement group. Conclusions. The increased mast cell count and degranulation are identified in MC, suggesting that mast cell activation might be involved in the pathogenesis of MC.

Microscopic colitis: lymphocytic and collagenous colitis

2002 ◽  
Vol 8 (1) ◽  
pp. 33-41 ◽  
Author(s):  
D. Treanor ◽  
K. Sheahan
Keyword(s):  
Collagenous Colitis ◽  
Microscopic Colitis

scholarly journals Microscopic Colitis and Medication Use

2010 ◽  
Vol 3 ◽  
pp. CGast.S4469 ◽  
Author(s):  
Monina F. Pascua ◽  
Prashant Kedia ◽  
Mark G. Weiner ◽  
John Holmes ◽  
Jonas Ellenberg ◽  
...  
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Index Date ◽  
Case Reports ◽  
Medication Use ◽  
Collagenous Colitis ◽  
Electronic Medical Record System ◽  
Microscopic Colitis ◽  
Record System ◽  
Reductase Inhibitors ◽  
Primary Care Practices

Background The incidence of microscopic colitis (MC) is increasing, but its etiology remains unknown. Case reports and limited controlled data suggest that commonly prescribed drugs may be triggers. The aim of this study was to evaluate the prevalence of selected medication use [Proton pump inhibitors (PPIs), HMG-CoA reductase inhibitors (statins), and Selective serotonin reuptake inhibitors (SSRIs)] in patients with MC compared to ‘random controls’ and ‘diarrhea controls.' Methods All patients were selected from primary care practices of a university health system during 2002 to 2007. Patients with biopsy proven lymphocytic or collagenous colitis were identified as cases. Diarrhea controls consisted of a 10:1 random sample of patients with chronic diarrhea and normal colon biopsies. Ten random controls were matched to each case on sex and index date (date of biopsy proven diagnosis). Drugs prescribed within the year prior to the index date were collected from the electronic medical record system. Results 26 cases (median age 68.9 yrs), 259 random, and 259 diarrhea controls were identified. The adjusted ORs for PPI, SSRI, and statin prescription within 12 months of diagnosis of MC between cases and diarrhea controls were 0.28 (0.07-1.07), 0.87 (0.28-2.64), 1.12 (0.34-3.71) respectively. Use of PPI and statins was less common in MC patients than in random controls ( P < 0.05 for both comparisons). Conclusions While prior data suggest that PPIs, statins, and SSRIs may be etiologically related to MC, our study found no increased association with these drugs.

scholarly journals Microscopic Colitis: Epidemiology, Pathophysiology, Diagnosis and Current Management—An Update 2013

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Martin Alexander Storr
Keyword(s):  
Colonic Mucosa ◽  
Chronic Diarrhea ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Collagenous Colitis ◽  
Microscopic Colitis ◽  
Normal Colonic Mucosa ◽  
Clinical Value ◽  
Current Management ◽  
And Gender

Microscopic colitis is a common cause of chronic diarrhea. Over the last years the incidence and the prevalence of microscopic colitis are rising and this rise is largely attributed to a rising awareness, and concomitantly an increasing number of diagnoses are made. Patients with microscopic colitis report watery, nonbloody diarrhea of chronic, intermittent, or chronic recurrent course. Following an unremarkable physical examination the diagnosis of microscopic colitis is made by colonoscopy, which shows essentially a normal colonic mucosa. Biopsies taken during the colonoscopy procedure will then finally establish the correct diagnosis. Histological workup can then confirm a diagnosis of microscopic colitis and can distinguish the two distinct histological forms, namely, collagenous colitis and lymphocytic colitis. Presently both forms are diagnosed and treated in the same way; thus the description of the two forms is not of clinical value, though this may change in future. Depending on the patients age and gender 10–30% of patients investigated for chronic diarrhea will be diagnosed with microscopic colitis if biopsies are taken. Microscopic colitis is most common in older patients, especially in female patients and is frequently associated with autoimmune disorders and the consumption of several drugs. This review summarizes the present knowledge of the epidemiology, the pathophysiology, and the diagnosis of microscopic colitis and discusses the former and the present treatment options.

Microscopic colitis, collagenous colitis, and mast cells

1990 ◽  
Vol 35 (7) ◽  
pp. 920-921 ◽  
Author(s):  
Georges J. -M. Molas ◽  
Jean F. Flejou ◽  
Fran�ois Potet
Keyword(s):  
Mast Cells ◽  
Collagenous Colitis ◽  
Microscopic Colitis
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