Collagenous colitis: an unrecognised entity.

Abstract

SUMMARY A patient is reported with chronic abdominal pain, diarrhoea, and associated radiological and endoscopic abnormalities of the sigmoid colon. Light and electron microscopic study of colorectal mucosa showed abnormal collagenous thickening of the subepithelial basement membrane. The authors felt that the clinical and morphological features justified a diagnosis of collagenous colitis. Review of the literature suggested that collagenous colitis was still an unrecognised entity. Lindstrom (1976) recorded the first case of an hitherto undescribed entity for which he suggested the term 'collagenous colitis'. Lindstrom's report concerned a 48 year old woman with chronic watery diarrhoea; a rectal biopsy showed a heavy collagenous deposit in the mucosal basement membrane. To our knowledge, no further description of this singular entity has appeared in the literature.We

Collagenous Colitis: A Clinicopathological Review

“…7] when this comparison was made, the results showed that the thickness of the basement membrane was definitely abnormal in patients with col lagenous colitis. Furthermore, these results [2,7] would preclude the suggestion made by Whitehead [16] that collagenous colitis may be part of a normal spectrum. In a recent study [17] of a known case of collagenous colitis [2], we used an in direct immunofluorescence technique which showed an increased deposition of anticol lagen types I and III as well as antifibronectin antibodies at the site of the thickened collag enous deposit.…”

“…Furthermore, these results [2,7] would preclude the suggestion made by Whitehead [16] that collagenous colitis may be part of a normal spectrum. In a recent study [17] of a known case of collagenous colitis [2], we used an in direct immunofluorescence technique which showed an increased deposition of anticol lagen types I and III as well as antifibronectin antibodies at the site of the thickened collag enous deposit. It is interesting to note that other immunofluorescence attempts have failed to identify immunoglobulins, comple ment, albumin or fibrinogen in the thickened basement membrane of collagenous colitis.…”

“…Col lagenous colitis was first recognized in 1976 by Lindström [1] who believed that the wa tery diarrhea was a result of the collagenous deposit and consequently coined the term 'collagenous colitis'. Since 1980, a number of additional case reports of collagenous colitis have been published [2][3][4][5][6][7][8][9][10][11][12], as well as one editorial [13] and some lively correspon dence [14. 15] on the subject.…”

Subepithelial basement membrane thickness in patients with normal colonic mucosal appearance in colonoscopy: Results from southern Turkey

“…Some investigators consider thickness >10 µm to be diagnostic, whereas others use >15 µm, and still others >30 µm [3,[5][6][7]11] . The SEBM thickness documented in cases of collagenous colitis in the English literature range from 11.5 to 60 µm [6,[13][14][15][16][17][18] . In a study of 564 patients conducted in 1982, the authors identified >10 µm in thickness as abnormal [14] .…”

Simultaneous Occurrence of Collagenous Colitis and Crohn’s Disease

“…Third, the thickness of the subepithelial collagenous band has generally attracted most attention [14], with less reference to the accompanying inflammatory cell infiltrate [3,5,6]. It is likely that the inflammatory component of this disease results in watery diarrhoea, just as it does in microscopic coli tis [15].…”