BACKGROUND: For patients with ulcerative colitis (UC) who have colonoscopy while their disease is in clinical remission, the clinical implications of finding histologic abnormalities of colitis are not clear. METHODS: We reviewed the medical records of patients with UC who had elective colonoscopy at our VA Medical Center while their UC was in clinical remission and who had at least 6 months of follow-up data available. The Mayo endoscopic subscore was used to assess endoscopic disease activity. Biopsies were evaluated for specific changes in the following general categories: acute inflammation, chronic inflammation, epithelial damage, and architectural distortion. RESULTS: We identified 51 patients with UC who had a total of 84 colonoscopies (at least 1 year apart) while they were in clinical remission. Forty colonoscopies revealed no endoscopic activity (Mayo subscore 0) and 44 showed endoscopic activity (Mayo subscore 1, 2, or 3). Although flares were approximately twice as common in patients with endoscopic activity as in those with an endoscopically normal mucosa, the difference was not statistically significant. On histologic evaluation, in contrast, the presence of basal lymphoplasmacytosis, basally located lymphoid aggregates, erosions and/or ulcerations of the epithelium, or moderate to marked architectural distortion all were significant predictors of clinical flares by 6 and 12 months. CONCLUSIONS: For patients with UC who have colonoscopy while their disease is in clinical remission, colonic biopsy seems to provide important prognostic information beyond that provided by the endoscopic assessment of disease activity alone.
BACKGROUND: For patients with ulcerative colitis (UC) who have colonoscopy while their disease is in clinical remission, the clinical implications of finding histologic abnormalities of colitis are not clear. METHODS: We reviewed the medical records of patients with UC who had elective colonoscopy at our VA Medical Center while their UC was in clinical remission and who had at least 6 months of follow-up data available. The Mayo endoscopic subscore was used to assess endoscopic disease activity. Biopsies were evaluated for specific changes in the following general categories: acute inflammation, chronic inflammation, epithelial damage, and architectural distortion. RESULTS: We identified 51 patients with UC who had a total of 84 colonoscopies (at least 1 year apart) while they were in clinical remission. Forty colonoscopies revealed no endoscopic activity (Mayo subscore 0) and 44 showed endoscopic activity (Mayo subscore 1, 2, or 3). Although flares were approximately twice as common in patients with endoscopic activity as in those with an endoscopically normal mucosa, the difference was not statistically significant. On histologic evaluation, in contrast, the presence of basal lymphoplasmacytosis, basally located lymphoid aggregates, erosions and/or ulcerations of the epithelium, or moderate to marked architectural distortion all were significant predictors of clinical flares by 6 and 12 months. CONCLUSIONS: For patients with UC who have colonoscopy while their disease is in clinical remission, colonic biopsy seems to provide important prognostic information beyond that provided by the endoscopic assessment of disease activity alone.
Authors: Brendan Halloran; Jessica Chang; David Q Shih; Dermot McGovern; Konrad Famulski; Chad Evaschesen; Richard N Fedorak; Aducio Thiesen; Stephan Targan; Philip F Halloran Journal: Inflamm Bowel Dis Date: 2014-12 Impact factor: 5.325
Authors: M H Collins; L J Martin; E S Alexander; J Todd Boyd; R Sheridan; H He; S Pentiuk; P E Putnam; J P Abonia; V A Mukkada; J P Franciosi; M E Rothenberg Journal: Dis Esophagus Date: 2017-02-01 Impact factor: 3.429
Authors: Britt Christensen; Stephen B Hanauer; Jonathan Erlich; Olufemi Kassim; Peter R Gibson; Jerrold R Turner; John Hart; David T Rubin Journal: Clin Gastroenterol Hepatol Date: 2017-02-24 Impact factor: 11.382
Authors: Corinna Lang-Schwarz; Abbas Agaimy; Raja Atreya; Christoph Becker; Silvio Danese; Jean-François Fléjou; Nikolaus Gaßler; Heike I Grabsch; Arndt Hartmann; Kateřina Kamarádová; Anja A Kühl; Gregory Y Lauwers; Alessandro Lugli; Iris Nagtegaal; Markus F Neurath; Georg Oberhuber; Laurent Peyrin-Biroulet; Timo Rath; Robert Riddell; Carlos A Rubio; Kieran Sheahan; Herbert Tilg; Vincenzo Villanacci; Maria Westerhoff; Michael Vieth Journal: Virchows Arch Date: 2020-12-29 Impact factor: 4.064
Authors: Corinna Lang-Schwarz; Miriam Angeloni; Abbas Agaimy; Raja Atreya; Christoph Becker; Theresa Dregelies; Silvio Danese; Jean-François Fléjou; Nikolaus Gaßler; Heike I Grabsch; Arndt Hartmann; Kateřina Kamarádová; Anja A Kühl; Gregory Y Lauwers; Alessandro Lugli; Iris Nagtegaal; Markus F Neurath; Georg Oberhuber; Laurent Peyrin-Biroulet; Timo Rath; Robert Riddell; Carlos A Rubio; Kieran Sheahan; Britta Siegmund; Herbert Tilg; Vincenzo Villanacci; Maria Westerhoff; Fulvia Ferrazzi; Michael Vieth Journal: J Crohns Colitis Date: 2021-10-07 Impact factor: 9.071