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International Journal of Colorectal Disease

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01-09-2007 | Original Article

Microscopic colitides: a single center experience in Mexico

Authors: Alberto Rubio-Tapia, Julio Martínez-Salgado, Jorge García-Leiva, Braulio Martínez-Benítez, Misael Uribe

Published in: International Journal of Colorectal Disease | Issue 9/2007

Abstract

Background/aim

Microscopic colitis is characterized by chronic diarrhea and specific microscopic changes in a macroscopically normal colonic mucosa. In this paper, we report the clinical and histological features of a group of Mexican patients with microscopic colitis.

Materials and methods

Patients were identified from 10 years of data in the pathology database of our institution. A pathologist reassessed all biopsy material. We included only patients who met strict histopathological criteria. Clinical data were obtained from medical records.

Results

Microscopic colitis was diagnosed in 26 cases. The female/male ratio was 1.8:1. The median age at diagnosis was 56.5 ± 15.7 (range, 26–85) years. The most frequent symptoms were diarrhea in all, weight loss in 22 (84%), and abdominal pain in 18 (69%) patients. Sixteen (61%) patients reported associated diseases; autoimmune thyroid disorders were the most common. Drug-induced microscopic colitis was suspected in 12 (46%) patients. More than 80% of the treated patients improved or had clinical remission.

Conclusion

Microscopic colitis is an uncommon colonic disease at our institution, representing less than 1% of the final diagnoses in mucosal colonic biopsies. It is the largest case series of microscopic colitis in the Mexican population.

Pardi DS, Smyrk TC, Tremaine WJ, Sandborn WJ (2002) Microscopic colitis: a review. Am J Gastroenterol 97:794–802PubMedCrossRef

Robert ME (2004) Microscopic colitis: pathologic considerations, changing dogma. J Clin Gastroenterol 38:S18–S26PubMedCrossRef

Fernandez BF, Salas A, Forne M, Esteve M, Espinos J, Viverm JM (1999) Incidence of collagenous and lymphocytic colitis: A 5-year population-based study. Am J Gastroenterol 94(2):418–423

Lizardi-Cervera J, Moran-Villota S, Hinojo-Rivas E, Reynoso-Mendoza R, Correa-Rovelo JM, Pichardo-Bahena R, Uribe M (2002) Microscopic colitis. Rev Gastroenterol Mex 67:47–52PubMed

Garg PK, Singh J, Dhali GK, Mathur M, Sharma MP (1996) Microscopic colitis is a cause of large bowel diarrhea in Northern India. J Clin Gastroenterol 22:11–15PubMedCrossRef

Barta Z, Mekkel G, Csipo I, Toth L, Szakall S, Szabo GG, Bako G, Szegedi G, Zeher M (2005) Microscopic colitis: a retrospective study of clinical presentation in 53 patients. World J Gastroenterol 11:1351–1355PubMed

Olesen M, Eriksson S, Bohr J, Järnerot G, Tysk C (2004) Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Orebro, Sweden, 1993–1998. Gut 53:346–350PubMedCrossRef

Olesen M, Ericksson S, Bohr J, Järnerot G, Tysk C (2004) Lymphocytic colitis: a retrospective clinical study of 199 Swedish patients. Gut 53:536–541PubMedCrossRef

Carpenter HA, Talley NJ (2000) The importance of clinicopathological correlation in the diagnosis of inflammatory conditions of the colon: histological patterns with clinical implications. Am J Gastroenterol 95:878–896PubMedCrossRef

10.

Schiller LR (2004) Diagnosis and management of microscopic colitis syndrome. J Clin Gastroenterol 38:S27–S30PubMedCrossRef

11.

Fine KD, Do K, Schulte K, Ogunji F, Guerra R, Osowski L, McCormack J (2000) High prevalence of celiac sprue-like HLA–DQ genes and enteropathy in patients with the microscopic colitis syndrome. Am J Gastroenterol 95:1974–1982PubMedCrossRef

12.

Fine KD, Lee EL (1998) Efficacy of open-label bismuth subsalicylate for the treatment of microscopic colitis. Gastroenterology 114:29–36PubMedCrossRef

13.

Stroehlein JR (2003) Microscopic colitis. Curr Opin Gastroenterol 20:27–31CrossRef

14.

Matteoni CA, Goldblum JR, Wang N et al (2001) Celiac disease is highly prevalent in lymphocytic colitis. J Clin Gastroenterol 32:225–227PubMedCrossRef

15.

Riddell RH, Tanaka M, Mazzoleni G (1992) Non-steroidal anti-inflammatory drugs as a possible cause of collgenous colitis: a case-control study. Gut 33:683–686PubMedCrossRef

16.

Tremaine WJ (2000) Collagenous colitis and lymphocytic colitis. J Clin Gastroenterol 30:245–249PubMedCrossRef

17.

Tagkaladis P, Bathal P, Gibson P (2002) Microscopic colitis. J Gastroenterol Hepatol 17:236–248CrossRef

18.

Zins BJ, Sandborn WJ, Tremaine WJ (1995) Collagenous and lymphocytic colitis: a subject to review and therapeutic alternatives. Am J Gastroenterol 90:1394–1400PubMed

19.

Pardi DS (2004) Microscopic colitis: an update. Inflamm Bowel Dis 10:860–870PubMedCrossRef

20.

Waschke KA, Marcus VA, Bitton A (2002) The atypical colitides. Gastroenterol Clin North Am 3:293–305CrossRef

21.

Beaugerie L, Luboinsky J, Brousse N et al (1994) Drug induced lymphocytic colitis. Gut 35:426–428PubMedCrossRef

22.

Beaugerie L, Patey N, Brousse N (1995) Ranitidine, diarrhea, and lymphocytic colitis. Gut 37:708–711PubMedCrossRef

23.

Thomson RD, Lestina LS, Bensen SP et al (2002) Lansoprazole-associated microscopic colitis: a case series. Am J Gastroenterol 97:2908–2913PubMed

24.

Mukherjee S (2003) Diarrhea associated with lansoprazole. J Gastroenterol Hepatol 18:602–603PubMedCrossRef

25.

Beaugerie L, Pardi DS (2005) Review article: drug-induced microscopic colitis—proposal for a scoring system and review of the literature. Aliment Pharmacol Ther 22:277–284PubMedCrossRef

26.

Fine KD, Ogunji F, Lee EL et al (1999) Randomized, double blind placebo controlled trial of bismuth subsalicylate for microscopic colitis. Gastroenterology 116:A880CrossRef

27.

Munk LK, Kjelsen E, Philipsen E et al (2003) Incomplete remission with short-term prednisolone treatment of collagenous colitis: a randomized study. Scand J Gastroenterol 38:606–610CrossRef

28.

Bonderup OK, Hansen JB, Birket-Smith L et al (2003) Budesonide treatment of collagenous colitis: a randomized, double blind, placebo controlled trial with morphometric analysis. Gut 52:248–251PubMedCrossRef

29.

Pardi DS, Loftus EV, Tremaine WJ et al (2001) Treatment of refractory microscopic colitis with azathioprine and 6-mercaptopurine. Gastroenterology 120:1483–1484PubMedCrossRef

30.

Kitchen PA, Levi AJ, Domizio P, Talbot IC, Forbes A, Price AB (2002) London inflammatory bowel disease forum. Microscopic colitis: the tip of the iceberg? Eur J Gastroenterol Hepatol 14(11):1199–1204PubMedCrossRef

31.

Agnarsdottir M, Gunnlaugsson O, Orvar KB, Cariglia N, Birgisson S, Bjornsson S, Thorgeirsson T, Jonasson JG (2002) Collagenous and lymphocytic colitis in Iceland. Dig Dis Sci 47(5):1122–1128PubMedCrossRef

32.

Pardi DS, Ramnath VR, Loftus EV Jr, Tremaine WJ, Sandborn WJ (2002) Lymphocytic colitis: clinical features, treatment, and outcomes. Am J Gastroenterol 97(11):2829–2833PubMedCrossRef

33.

Abdo A, Raboud J, Freeman HJ, Zetler P, Tilley J, Chaun H, Whittaker JS, Amar J, Halparin L, Enns R (2002) Clinical and histological predictors of response to medical therapy in collagenous colitis. Am J Gastroenterol 97(5):1164–1168PubMedCrossRef

Title: Microscopic colitides: a single center experience in Mexico
Authors: Alberto Rubio-Tapia
Julio Martínez-Salgado
Jorge García-Leiva
Braulio Martínez-Benítez
Misael Uribe
Publication date: 01-09-2007
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 9/2007
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-006-0258-7

At a glance: The STEP trials

Springer Medicine

Microscopic colitides: a single center experience in Mexico

Abstract

Background/aim

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background/aim

Materials and methods

Results

Conclusion

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