Literature DB >> 15290914

The clinical significance of right-sided colonic inflammation in patients with left-sided chronic ulcerative colitis.

Muthoka L Mutinga1, Robert D Odze, Helen H Wang, Jason L Hornick, Francis A Farraye.   

Abstract

BACKGROUND: Rarely, patchy right colonic inflammation has been observed in patients with left sided chronic ulcerative colitis (CUC), but the clinical significance of this finding is unknown. Therefore, the aim of this study was to evaluate the clinical and pathologic features and natural history of CUC patients with left-sided colitis combined with patchy right colonic inflammation and to compare the clinical course to a control group of patients with isolated left-sided CUC.
METHODS: Twelve patients with clinically and pathologically confirmed left-sided CUC, but also with patchy right colonic inflammation, were identified from a cohort of 352 consecutive patients with CUC who underwent colonoscopy at the Brigham and Women's Hospital between 1996 and 2000. In this cohort, 127 patients had left-sided colitis. As the first study to use controls in this setting, 35 consecutive patients with left-sided CUC, but without patchy right colonic inflammation, were selected and evaluated during the same time period. In all patients, the medical records were reviewed for a wide variety of clinical, endoscopic, and pathologic features. The mean follow-up time for the study and control groups was 105 +/- 128 and 112 +/- 80 months, respectively.
RESULTS: Patients in the study group were significantly older than the control group at the time of diagnosis (47 +/- 17 years vs 35 +/- 14 years, p = 0.048), but the two groups had a similar gender distribution (25% male vs 40% male), prevalence of extraintestinal manifestations (25% vs 11%), frequency of nonsteroidal anti-inflammatory drug use (75% vs 50%), family history of colitis (27% vs 15%), current tobacco use (8% vs 3%), history of appendectomy (8% vs 0%), and overall severity of disease (33% vs 46%). None of the patients in the study group, and only one control patient, had disease progression to pancolitis. One study patient developed high-grade dysplasia in the rectum that required a colectomy. None of the study or control patients developed clinical or pathologic features of Crohn's disease.
CONCLUSIONS: Rarely patients with left-sided CUC may have patchy right colonic inflammation. The clinical features and natural history of patients with left-sided CUC and patchy right colonic inflammation is similar to patients with isolated left-sided CUC.

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Year:  2004        PMID: 15290914     DOI: 10.1097/00054725-200405000-00006

Source DB:  PubMed          Journal:  Inflamm Bowel Dis        ISSN: 1078-0998            Impact factor:   5.325


  10 in total

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Journal:  Tech Coloproctol       Date:  2007-05-25       Impact factor: 3.781

2.  Atypical distribution of inflammation in newly diagnosed ulcerative colitis is not rare.

Authors:  Sang Hyoung Park; Suk-Kyun Yang; Soo-Kyung Park; Jong Wook Kim; Dong-Hoon Yang; Kee Wook Jung; Kyung-Jo Kim; Byong Duk Ye; Jeong-Sik Byeon; Seung-Jae Myung; Jin-Ho Kim
Journal:  Can J Gastroenterol Hepatol       Date:  2014-03

3.  The peri-appendiceal red patch in ulcerative colitis: review of the University of Chicago experience.

Authors:  David T Rubin; Jami A Rothe
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4.  Histologic markers of inflammation in patients with ulcerative colitis in clinical remission.

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Review 5.  Appendiceal skip inflammation and ulcerative colitis.

Authors:  Sang Hyoung Park; Edward V Loftus; Suk-Kyun Yang
Journal:  Dig Dis Sci       Date:  2014-04-05       Impact factor: 3.199

6.  Detection of colonic inflammation with Fourier transform infrared spectroscopy using a flexible silver halide fiber.

Authors:  Vinay K Katukuri; John Hargrove; Sharon J Miller; Kinan Rahal; John Y Kao; Rolf Wolters; Ellen M Zimmermann; Thomas D Wang
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7.  Spatial Evolution of Histologic and Endoscopic Healing in the Left and Right Colon in Patients With Ulcerative Colitis.

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9.  Maximizing the diagnostic information from biopsies in chronic inflammatory bowel diseases: recommendations from the Erlangen International Consensus Conference on Inflammatory Bowel Diseases and presentation of the IBD-DCA score as a proposal for a new index for histologic activity assessment in ulcerative colitis and Crohn's disease.

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Review 10.  Histological evaluation in ulcerative colitis.

Authors:  Tom C DeRoche; Shu-Yuan Xiao; Xiuli Liu
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  10 in total

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