Collagenous colitis: Histologic, morphometric, immunohistochemical and ultrastructural studies. Report of 21 cases

Widgren, S; Jlidi, R.; Cox, Jeremiah N.

doi:10.1007/bf00783020

Cited by 66 publications

(26 citation statements)

References 35 publications

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“…These bands have been shown to consist mainly of different collagen types, such as VI, III, and I, but they also contain the glycoprotein tenascin [1,8]. They are most likely derived from an abnormal matrix accumulation around the pericryptal fibroblast sheath [1,9,22]. Collagenous colitis is unrelated to other forms of inflammatory bowel disease, such as chronic ulcerative colitis and Crohn's disease, and it requires a different patient management [7,20], although some evidence exists about transitions from collagenous colitis towards ulcerative colitis and from lymphocytic colitis to collagenous colitis.…”

Section: Discussionmentioning

confidence: 99%

Tenascin: a sensitive and specific diagnostic marker of minimal collagenous colitis

et al. 2001

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Collagenous colitis is a rare cause of chronic watery diarrhea. In this condition, endoscopic findings are usually normal. Currently, the diagnosis relies on the histological presence of thick subepithelial bands of collagen deposits and an inflammatory infiltrate within the mucosa. However, these subepithelial bands may be developed only focally and may be too subtle to allow a definitive diagnosis upon routine hematoxylin and eosin (HE) and van Gieson's stainings. Recently, we and others were able to show a prominent staining of tenascin and type-VI collagen in the subepithelial band-like structures. In this study, we tested the diagnostic value of tenascin staining and type-VI collagen immunolocalization for the identification of collagenous colitis and compared it with conventional histology and histochemical detection of collagens. The analysis was based on 434 biopsy specimens of collagenous colitis, other forms of colitis, and normal mucosa. We were able to show that the immunohistochemical detection of increased amounts of tenascin, selectively in the subepithelial zone, is a specific test for collagenous colitis, with a sensitivity superior to conventional histological and histochemical detection, especially in minimal collagenous colitis (P<0.001). Of note, tenascin staining also allows the diagnosis of collagenous colitis in biopsies obtained only from the rectum and sigmoid colon, thus avoiding the need for colonoscopic investigations. Tenascin immunostaining is a simple and safe tool to complement conventional histological diagnostics in clinically and histopathologically unclear cases of diarrhea.

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Section: Discussionmentioning

confidence: 99%

Tenascin: a sensitive and specific diagnostic marker of minimal collagenous colitis

et al. 2001

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“…2,6,13 Furthermore, for CC, myofibroblast dysfunction has been described. [14][15][16] Finally, noxious luminal substances such as drugs and smoking may trigger the chronic inflammation seen in MC and one postulated hypothesis points to increased colonic permeability in MC patients, thereby allowing luminal antigens to enter the lamina propria and elicit an immune and inflammatory reaction. 17 The increasing incidence of MC may partially be explained by an increased awareness of the condition among clinicians and histopathologists.…”

mentioning

confidence: 98%

Is Microscopic Colitis a Drug-induced Disease?

Keszthelyi¹,

Penders

Masclee³

et al. 2012

Journal of Clinical Gastroenterology

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Microscopic colitis (MC) is diagnosed in up to 13% of patients investigated for chronic diarrhea, particularly in middle-aged and elderly patients. Recent studies have suggested an etiological role for various drugs, including nonsteroidal anti-inflammatory drugs and proton pump inhibitors. To ascertain the potential role for drug exposure in the development of MC, we performed a systematic review based on a MEDLINE search and conducted a meta-analyses on the available data. We also give an overview of the case reports and studies illustrating the role of drugs in inducing MC. A number of hypotheses are formulated with regard to the potential pathophysiological mechanisms in drug-induced MC. However, confirmative evidence is still largely lacking. Considering the high number of drug users and the relatively low incidence of MC, it is more likely that drug-induced cases of MC are the result of an idiosyncratic reaction.

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“…These pathological features are analogous to those reported earlier in collagenous sprue [2] . Ultrastructural studies have confirmed that the deposits consist of collagen fibers [3] . Most often, middle-aged to elderly females are affected, although even children have been reported with collagenous colitis [1,4] .…”

Section: Collagenous Colitismentioning

confidence: 84%