Julie Rasmussen1, Peter Johan Heiberg Engel2, Signe Wildt1, Anne-Marie Kanstrup Fiehn3, Lars Kristian Munck4. 1. Department of Medicine, Køge University Hospital, Køge, Denmark. 2. Department of Pathology, Roskilde University Hospital, Roskilde, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 3. Department of Pathology, Roskilde University Hospital, Roskilde, Denmark. 4. Department of Medicine, Køge University Hospital, Køge, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark lkmu@regionsjaelland.dk.
Abstract
BACKGROUND AND AIMS: Microscopic colitis (MC) is a common cause of chronic watery diarrhoea but long-term follow-up data are sparse. METHODS: We performed a retrospective review of health records and all pathology reports in a regional cohort of patients with MC to describe the change in pre- and post-diagnostic colon biopsies. RESULTS: MC was diagnosed in 468 patients with collagenous colitis (CC), 361 with lymphocytic colitis (LC) and 226 with incomplete MC (MCi). The 2014 incidence of CC, LC and MCi was 14.5, 14.9 and 5 per 10(5). Biopsies from both right and left colon were obtained in 237 (51%) patients with CC, 200 (55%) with LC and 107 (47%) with MCi. The diagnostic sensitivities of both left- and right-sided biopsies for MC were high and did not differ. Pre-diagnostic biopsies were obtained in 150 patients and lamina propria inflammation was described in 59, 47 and 43% of patients with a diagnosis of CC, LC and MCi respectively within 1 year, while histology was normal in 16, 13 and 21%. Post-diagnostic biopsies were obtained in 283 patients. MC persisted for up to one year in 77% with CC, 64% with LC and 45% with MCi, of whom 6, 9 and 18% respectively changed to a different MC subgroup. CONCLUSIONS: Colonic biopsies obtained prior to the MC diagnosis often revealed increased lamina propria inflammation. The pathological changes of CC and LC are more persistent than those of MCi. Biopsies from the descending or sigmoid colon are sufficient to elucidate whether a patient with chronic watery diarrhoea has MC.
BACKGROUND AND AIMS: Microscopic colitis (MC) is a common cause of chronic watery diarrhoea but long-term follow-up data are sparse. METHODS: We performed a retrospective review of health records and all pathology reports in a regional cohort of patients with MC to describe the change in pre- and post-diagnostic colon biopsies. RESULTS: MC was diagnosed in 468 patients with collagenous colitis (CC), 361 with lymphocytic colitis (LC) and 226 with incomplete MC (MCi). The 2014 incidence of CC, LC and MCi was 14.5, 14.9 and 5 per 10(5). Biopsies from both right and left colon were obtained in 237 (51%) patients with CC, 200 (55%) with LC and 107 (47%) with MCi. The diagnostic sensitivities of both left- and right-sided biopsies for MC were high and did not differ. Pre-diagnostic biopsies were obtained in 150 patients and lamina propria inflammation was described in 59, 47 and 43% of patients with a diagnosis of CC, LC and MCi respectively within 1 year, while histology was normal in 16, 13 and 21%. Post-diagnostic biopsies were obtained in 283 patients. MC persisted for up to one year in 77% with CC, 64% with LC and 45% with MCi, of whom 6, 9 and 18% respectively changed to a different MC subgroup. CONCLUSIONS: Colonic biopsies obtained prior to the MC diagnosis often revealed increased lamina propria inflammation. The pathological changes of CC and LC are more persistent than those of MCi. Biopsies from the descending or sigmoid colon are sufficient to elucidate whether a patient with chronic watery diarrhoea has MC.
Authors: Beth H Shaz; Sarathchandra I Reddy; Gamze Ayata; Tom Brien; Francis A Farraye; Donald A Antonioli; Robert D Odze; Helen H Wang Journal: Mod Pathol Date: 2004-04 Impact factor: 7.842
Authors: Darrell S Pardi; Venktesh R Ramnath; Edward V Loftus; William J Tremaine; William J Sandborn Journal: Am J Gastroenterol Date: 2002-11 Impact factor: 10.864
Authors: Fernando Fernández-Bañares; Antonio Salas; Maria Esteve; Jorge Espinós; Montserrat Forné; Josep Maria Viver Journal: Am J Gastroenterol Date: 2003-02 Impact factor: 10.864
Authors: David Limsui; Darrell S Pardi; Thomas C Smyrk; Susan C Abraham; Jason T Lewis; Schuyler O Sanderson; Patricia P Kammer; Ross A Dierkhising; Alan R Zinsmeister Journal: Inflamm Bowel Dis Date: 2009-01 Impact factor: 5.325
Authors: Laura Francesca Pisani; Gian Eugenio Tontini; Beatrice Marinoni; Vincenzo Villanacci; Barbara Bruni; Maurizio Vecchi; Luca Pastorelli Journal: Front Med (Lausanne) Date: 2017-05-10
Authors: Ingunn Bakke; Gunnar Andreas Walaas; Torunn Bruland; Elin Synnøve Røyset; Atle van Beelen Granlund; Celia Escudero-Hernández; Silje Thorsvik; Andreas Münch; Arne Kristian Sandvik; Ann Elisabet Østvik Journal: J Gastroenterol Date: 2021-08-19 Impact factor: 7.527
Authors: Stephan Miehlke; Danila Guagnozzi; Yamile Zabana; Gian E Tontini; Anne-Marie Kanstrup Fiehn; Signe Wildt; Johan Bohr; Ole Bonderup; Gerd Bouma; Mauro D'Amato; Peter J Heiberg Engel; Fernando Fernandez-Banares; Gilles Macaigne; Henrik Hjortswang; Elisabeth Hultgren-Hörnquist; Anastasios Koulaouzidis; Jouzas Kupcinskas; Stefania Landolfi; Giovanni Latella; Alfredo Lucendo; Ivan Lyutakov; Ahmed Madisch; Fernando Magro; Wojciech Marlicz; Emese Mihaly; Lars K Munck; Ann-Elisabeth Ostvik; Árpád V Patai; Plamen Penchev; Karolina Skonieczna-Żydecka; Bas Verhaegh; Andreas Münch Journal: United European Gastroenterol J Date: 2021-02-22 Impact factor: 4.623
Authors: Anne-Marie Kanstrup Fiehn; Martin Kristensson; Ulla Engel; Lars Kristian Munck; Susanne Holck; Peter Johan Heiberg Engel Journal: Clin Exp Gastroenterol Date: 2016-04-08