Associations of Microscopic Colitis With Other Lymphocytic Disorders of the Gastrointestinal Tract

Sonnenberg, Amnon; Turner, Kevin; Genta, Robert M.

doi:10.1016/j.cgh.2018.03.002

Cited by 40 publications

(43 citation statements)

References 22 publications

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“…Reports in the literature emphasise that FCC can vary in different age groups. FCC in infants is higher and drops to the level observed in adults in the fifth year of life [3]. In studies by Ertekin et al [7] and Balamtekin et al [8] the mean age of children with recently diagnosed CD was slightly higher than 6 years, compared with 9.1 years in our own study.…”

Section: Discussioncontrasting

confidence: 40%

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Faecal calprotectin concentration in children with coeliac disease

Szaflarska-Popławska

Romańczuk

Parzęcka

2020

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Introduction: It is still unknown whether faecal calprotectin elevation may be caused by active untreated coeliac disease (CD) itself or whether it indicates the coexistence of CD and another disease associated with gastrointestinal inflammation. Aim: To assess faecal calprotectin concentration (FCC) and its correlation with the clinical form and histopathological picture of the small intestine in children with CD. Material and methods: Fifty-five children with newly recognised CD (mean age: 9.1 years) and 17 children with CD diagnosed at least year before and on a strict gluten-free diet (mean age: 12.3 years) were accepted for the study. Classical (n = 27), non-classical (n = 17), and asymptomatic form (n = 11) were distinguished in children with newly diagnosed CD based on the clinical picture. The histopathological small intestinal lesions were classified as Marsh 1 (n = 4), 3a (n = 5), 3b (n = 20), and 3c (n = 26). FCC was assessed using ELISA method with 50 µg/g as the upper limit of the normal. Results: FCC was abnormal for 21 patients with newly diagnosed CD (38.2%) and for six patients from the treated group (35.3%). Mean FCC for the analysed group of patients was 91.7 ±144.8 µg/g, in the group with newly diagnosed CD-100.9 ±154.4 µg/g, and in the treated group-61.8 ±106.2 µg/g (Z =-1.333; p = 0.183). In the group of patients with recently diagnosed CD a statistically significant relationship was not observed for FCC and both clinical picture (c 2 = 0.319, p = 0.852) and severity of small intestinal lesions according to the Marsh classification (rho = 0.136). Conclusions: Assessment of FCC seems to have no use as a marker for diagnostics and monitoring of CD irrespective of clinical form of the disease and severity of the inflammatory lesions within the small intestine.

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Section: Discussioncontrasting

confidence: 40%

“…The high rate of comorbidity between inflammatory bowel diseases and CD has already been confirmed [2]. A recently published study also provides supporting evidence for a strong association between CD and microscopic colitis [3].…”

Section: Introductionmentioning

confidence: 63%

Faecal calprotectin concentration in children with coeliac disease

Szaflarska-Popławska

Romańczuk

Parzęcka

2020

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“…283 Incidence rates were between 2% and 4% in large cohort studies, 13,284 a case-control study 76 and one pathology registry including 3456 MC patients having undergone both gastroscopy and lower endoscopy with biopsy. 285 These estimates are larger than in the background populations, albeit lower than reported in numerous retrospective studies, mostly older case series and incomplete cohorts. 28,88,163,166,170,172,173,[286][287][288][289][290] Coeliac disease was mainly diagnosed by biochemical testing rather than histology and most studies screened only approximately half of the patients.…”

Section: Diagnosis Of MC What Is the Endoscopic Appearance Of Mc?mentioning

confidence: 72%

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

et al. 2021

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Introduction Microscopic colitis is a chronic inflammatory bowel disease characterised by normal or almost normal endoscopic appearance of the colon, chronic watery, non-bloody diarrhoea and distinct histological abnormalities, which identify three histological subtypes, the collagenous colitis, the lymphocytic colitis and the incomplete microscopic colitis. With ongoing uncertainties and new developments in the clinical management of microscopic colitis, there is a need for evidence-based guidelines to improve the medical care of patients suffering from this disorder. Methods Guidelines were developed by members from the European Microscopic Colitis Group and United European Gastroenterology in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. Following a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the certainty of the evidence. Statements and recommendations were developed by working groups consisting of gastroenterologists, pathologists and basic scientists, and voted upon using the Delphi method. Results These guidelines provide information on epidemiology and risk factors of microscopic colitis, as well as evidence-based statements and recommendations on diagnostic criteria and treatment options, including oral budesonide, bile acid binders, immunomodulators and biologics. Recommendations on the clinical management of microscopic colitis are provided based on evidence, expert opinion and best clinical practice. Conclusion These guidelines may support clinicians worldwide to improve the clinical management of patients with microscopic colitis.

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“…A previous study reported two colonic MEITL patients with clinicopathological features that mimicked those of ulcerative colitis and lymphocytic colitis, and the latter had a history of 'lymphocytic colitis' before 6 months [24]. Although collagenous sprue, microscopic (lymphocytic and collagenous) colitis, and celiac disease show distinct clinical entities, these diseases reveal similar features of colitis with an increase in T-IELs [25,26]. Five examined MEITL patients (56%) had features of lymphocytic proctocolitis with reactive small T-IELs, and the ndings were almost similar to lymphocytic colitis, in which more than 20 IELs per 100 epithelial cells and no or few distorted crypts were detected [27].…”

Section: Discussionmentioning

confidence: 91%

Endoscopic and clinicopathological characteristics of colorectal T/NK cell lymphoma

Ishibashi

Nimura

Hirai

et al. 2020

Preprint

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Background Colorectal T/NK cell lymphomas (TNKCL) were very rare. Endoscopic and clinicopathological characteristics of colorectal TNKCL have not been clearly demonstrated. In this study, we demonstrated the clinical characteristics of colorectal TNKCL.Methods Endoscopic and clinicopathological characteristics were investigated in 27 patients with colorectal monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), adult T-cell leukemia/lymphoma (ATLL), and other types of TNKCL.Results Nine TNKCL patients (33%) were classified as MEITL, 11 (41%) as ATLL, and seven (26%) as other. Four Epstein-Barr Virus (EBV) + TNKCL patients were categorized as other. Endoscopically, six MEITL (67%) and five ATLL (46%) showed diffuse-infiltrating type, in which the main endoscopic lesion was edematous mucosa in MEITL, while aphthoid erosion and edematous mucosa were typical in ATLL. Ulcerative type was identified in four other group patients (57%), including two EBV + TNKCL. More than two colorectal lymphomatous lesions were found in seven MEITL (78%) compared with one other group patient (14%) (P < 0.05). An increase in atypical T-intraepithelial lymphocytes (T-IELs) was noted in seven MEITL (88%) and six ATLL (60%) patients, but no other group (0%) patients. Five MEITL patients (56%) showed features of lymphocytic proctocolitis with increased CD8 + T-IELs.Conclusions MEITL and ATLL occasionally invaded the colorectum, and primary involving MEITL was observed. Diffuse infiltrating type was the characteristic endoscopic finding in colorectal MEITL and ATLL, and ulcerative type was observed in the other group. Features of lymphocytic proctocolitis may be prodromal findings of MEITL.

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Associations of Microscopic Colitis With Other Lymphocytic Disorders of the Gastrointestinal Tract

Cited by 40 publications

References 22 publications

Faecal calprotectin concentration in children with coeliac disease

Faecal calprotectin concentration in children with coeliac disease

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

Endoscopic and clinicopathological characteristics of colorectal T/NK cell lymphoma

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